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Building Community from a Distance

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VA's orthotics and prosthetics services are fully integrated into other areas of their care.

As aspiring practitioners in the field of Orthotics and Prosthetics (O&P), O&P residents face unique challenges that can best be addressed through collective efforts.

In this guest story, Léa Richer, MSOP, CPO and Nicholas Charon, MSPO, CP, share their experiences of building community during their residency program.

This story was written with assistance from Kirsten George, MSPO, CPO and Marion Gibney, MSPO, CPO.

By cultivating a sense of camaraderie and mutual understanding, O&P residents can share knowledge, exchange experiences, and develop essential skills that go beyond formal education. This interconnected community provides a platform for residents to navigate the complexities of patient care, technological advancements, and industry developments together, ultimately shaping them into well-rounded practitioners. The following is a reflection from two former Lead Residents from the Department of Veterans Affairs (VA) National Residency Program. This article describes the myriad of benefits that the existence of a strong community among O&P residents provides, and the efforts that the VA residency program has put in place to foster this sense of community.

The Lead Residents found that building a strong community within any professional setting yields numerous benefits. In the realm of O&P, fostering a sense of community among residents brings about improved patient care outcomes as those providing care collaborate and share information. Connecting O&P residents to each other, and/or to other clinicians (both in and out of O&P), creates a greater opportunity for collective problem-solving, leading to enhanced orthotic and prosthetic interventions. Networking within a community practice opens doors to collaboration, knowledge exchanges, and career growth, enabling future clinicians to broaden their horizons and stay updated with the latest advancements in O&P.

Building a resident community not only impacts patient care, but it also cultivates a sense of belonging, which can reduce feelings of isolation, promote mental well-being, and play a pivotal role in the prevention of burnout.

Through shared experiences, coping mechanisms, and mutual support, residents are afforded an outlet providing solace, recharge, and resilience. By mitigating burnout and fostering positive resident experiences, residents leave residency prepared with tools and networks to support future careers. These tools and networks influence the greater field of O&P by improving clinician retention and improving the quality of care provided to patients. Each year, VA's O&P residency program selects a resident in his or her second year of residency to serve as Lead Resident.

The Lead Resident position was created during the COVID-19 pandemic in 2020 to connect the O&P residents dispersed across the United States, as many are the only O&P resident in a specific hospital. The Lead Resident uses various strategies to foster a sense of community among VA residents, regardless of location. Monthly virtual meetings serve as the primary platform for collaboration and knowledge sharing. Guest speakers from various O&P and related organizations are invited to these meetings, providing an opportunity for residents to engage in focused discussions, exchange insights, and enhance understanding of O&P practices from multiple perspectives. These meetings also serve as a forum to discuss challenges residents experience with fabrication, patient care, work in a hospital and clinical setting, human resources, mentor interactions and relationships, and/or to ask for advice on specific cases. Optional virtual study groups are held once a month and offer residents an opportunity to engage in collaborative learning, sharing knowledge, exchanging insights, and reinforcing their understanding of board exam material. Through active participation in these study groups, residents can clarify doubts, discuss challenging concepts, and gain new insights. The study groups further enhance exam preparation, leading them to professional certification. For many residents, this is also a time to discuss frustrations, fears, and troubles experienced with the exam process. 

In-person networking opportunities further strengthen the community by fostering personal connections and solidarity among residents while reinforcing the network beyond typical virtual interactions. Within VA’s O&P residency program, the main example is the VA Breakout Session, conducted the day before the Annual Meeting & Scientific Symposium of the American Academy of Orthotists and Prosthetists (AAOP) begins.

One of the requirements of a VA residency is to complete a research project on an O&P topic chosen by the resident. The VA Breakout Session, at the AAOP meeting, provides an opportunity for residents to present their research as a presentation or in a poster format. This in-person event provides residents with the opportunity to meet colleagues face-to-face, communicating in a virtual setting. By integrating virtual meetings, study groups, and in-person social opportunities, O&P residents in VA can cultivate a thriving community that promotes learning, collaboration, and mutual support. Many of the connections built during residency extend far beyond the residency program creating community and friendships among junior clinicians as they begin their post-residency careers.

Technological difficulties can impede effective communication and collaboration, hindering the establishment of virtual connections and the seamless organization of online meetings. Some of the difficulties that have impeded the last two cohorts of residents were the lack of access to cameras, not being willing to turn on the camera, and the lack of a work environment quiet enough to participate in a meeting. Scheduling conflicts often arise due to the demanding nature of clinical care responsibilities, accommodating four time zones. Even with beginning-of-the-year surveys, it is difficult to find suitable times for monthly meetings that accommodate the availability of all residents and staff. Moreover, striking a balance between the time allocated to clinical care responsibilities and the commitment required for monthly meetings and/or study groups is challenging. Residents must manage their workload effectively to ensure patient care remains a priority while actively participating in these community-building efforts and activities.

Once learned, this skill will benefit them in later aspects of their careers. Overcoming these challenges necessitates effective communication, flexibility, and a shared commitment from all residents (and their individual leadership) to create a supportive community. Buying into the concept of community building is not needed from the residents and national leadership; it is essential and needed among local residency mentors and directors. In 2020, Kirsten George, CPO, was selected to be the first Lead Resident. Kirsten shared that initially the Lead Resident’s role was to see how other residents were coping with the pandemic and the changes it forced and/or mandated. There was some thought about bringing uniformity to the program, and Kirsten thought, “I can do that.” Though her role was focused on helping the residents, she found the experience to be a year of personal growth for herself as well.

Kirsten reflected on how the year helped her deepen connections with other residents and pass on critical information and experiences from one resident group to the next. Today, as a CPO, she expressed that this experience was instrumental to her success as a clinician in the private sector. She gained new perspective surrounding interdisciplinary care, communicating clearly within care teams, and writing up justifications as a clinician. As Lead Resident the following year, Léa experienced many of the same reactions as Kirsten. 

As the second Lead Resident, questions from residents were more detailed and nuanced as cumulative resident knowledge increased. Collaborating with a cohort of second-year residents, whose only work experience occurred during the COVID-19 pandemic, Léa faced both the pressure and the freedom to curate lectures that were engaging, interesting, enticing so that residents would attend and participate. With the ever-changing landscape of the pandemic, traveling for exams became even more stressful. The study group became a place not just to prepare residents for exams, but also to help them navigate pandemic travel restrictions. For Léa, this experience led to the creation of national connections across the VA for both residents and clinical staff while securing friendships with residents, both personally and professionally. This opportunity also allowed Lea to transfer to another VA for employment when her residency was over.

Nick was selected to be Lead Resident in 2022 after completing his first VA O&P residency in 2021. During his +me as Lead Resident, he continued to build upon the foundation created by Kirsten and Léa. Nick had limited prior experience in a leadership role such as this and learned lessons on effective decision-making and communication. Nick gained confidence as a leader and found his voice in group discussions. Now, as a new VA clinician, Nick plans to use the skills gained during his Lead Resident tenure by employing these leadership skills in a way that benefits all of the nation’s Veterans.

Establishing community with colleagues living a similar experience is something the VA worked to establish through the O&P residency programs. Former Lead Residents have learned that creating a resident community, regardless of the distance separating residents, has helped each resident become a more engaged clinician. O&P resident communities foster solidarity helping residents develop clinical thinking, improve problem solving, expand the resources and knowledge base, and mitigate the stresses associated when entering a career in healthcare.

About the Authors

Léa Richer, MSOP, CPO - Léa graduated from Concordia University St Paul, and the Century College Program in 2020. She completed both residencies at the VA Portland Health Care System in Portland Oregon in 2020-2022. In August 2022, Lea began working at the Edward Hines Jr VA Hospital in Hines, Illinois. At the annual meeting of the AAOP in February 2023, Léa presented results from a national research study focusing on mental health and prosthetics.

Nicholas Charon, MSPO, CP - Nicholas graduated from the University of Pittsburg Program in 2021 and completed both residencies at the Edward Hines Jr VA Hospital in 2021 2023. Nicholas began and continues his professional career working at the Danville VA Medical Center in Danville, Illinois.