Cody McDonald

Hafner BJ, Morgan SJ, McDonald CM, Kramer PA, Davidson GE. Walking performance, endurance, and perceived exertion in people with transitibal amputation: effects of a modified running-specific foot. OTWorld 2016 Congress, Leipzig, Germany, May 3-6, 2016 (submitted for podium presentation).

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Hafner BJ, Morgan SJ, McDonald CM, Kramer PA. Effects of a modified running foot prosthesis on users' endurance and perceived exertion. Academy of Orthotists & Prosthetists (AAOP) 42nd Annual Meeting and Scientific Symposium, Orlando, FL, March 9-12, 2015. (submitted for presentation)

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McDonald C, Hafner B. Critically Appraised Topic (CAT): Reduction in falls associated with use of microprocessor-controlled prosthetic knees among community ambulators with transfemoral amputation. American Academy of Orthotists & Prosthetists. 2015.

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McDonald C. A Year in Laos PDR. Northwest Chapter of the American Academy of Orthotists & Prosthetists (NWAAOP) Continuing Education Conference. Bellevue, WA, May 3-4, 2013.

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My international work has taken me to multiple countries, with my most substantial experience occurring in Laos PDR as an orthotist mentor in 2012. I worked with a local non-profit organization and was heavily involved in many programmatic aspects of the organization. I provided clinical mentorship to local staff, taught bi-monthly continuing education programs, supported the program manager with outreach programs, quarterly reports, organizational development and collaborative work with the Ministry of Health.

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Exceed is a non-profit organization that was established in 1989 to provide rehabilitation services in Cambodia. Exceed opened its first P&O school in Cambodia in 1994 (CSPO) and has since developed ISPO Category II educational programs in the Philippines, Sri Lanka, Indonesia, and Myanmar. Exceed students are drawn from countries across Southeast Asia, as most countries do not have their own accredited P&O schools. CSPO has graduated more than 150 students since it opened in 1994.4

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As a UW research prosthetist, I have been extensively involved in all aspects of smaller, intervention-based studies. I contributed to the original grant applications, internal review board applications, and development of study protocols and data collection forms. I have acted as both a team member and leader for this research study. I work in day to day scheduling and data collection, as well as, schedule and run bi-weekly meetings, assist with quarterly reports and participate in data collection, cleaning, and analysis.

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As a Global Health MPH student, I would like the opportunity to use my research, communication, teamwork, and teaching skills within the context of public health. I believe this RA opportunity at START is the ideal situation for me to further develop while contributing to a worthwhile and exciting program. Thank you for your consideration.

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NJB 13th Floor | 325 9th Ave. Seattle, WA 98104 | Box 359909

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Problem and Rationale: According to the World Health Organization (WHO), low and middle-income countries have an estimated disability prevalence of 18%, compared to 11.8% in high-income countries.1 Despite the increased presence of disabling conditions in low and middle-income countries, few people (i.e., only 5-15% of those in need) have access to the assistive technologies (e.g., prostheses, orthoses, wheelchairs) they require. The WHO has estimated that more than 30 million people across Africa, Asia, and Latin America are in need of prosthetic and orthotic services.2.

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General Objectives: The long-term goals of this project are to mitigate attrition of national prosthetist-orthotists from the P&O field in low and middle-income countries. The purpose of this study is to assess attrition of prosthetist-orthotists from the field, to characterize barriers to retention, and to identify opportunities to modify retention barriers. In this initial mixed-methods study, we will examine attrition of prosthetist-orthotists who have graduated from CSPO, one of the most established P&O programs in Southeast Asia. If successful, this study could be expanded to include graduates from other Exceed schools.

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Judicious provision of rehabilitation technologies, like prostheses and orthoses, requires a workforce trained with discipline-specific skills. Limited information exists about the current prosthetics and orthotics (P&O) workforce in comparison to the present need, but WHO estimates a need for 40,000 prosthetist-orthotists worldwide.2 To address the growing need for prosthetists-orthotists, the International Society for Prosthetics and Orthotics (ISPO), in collaboration with the United States Agency for International Development (USAID), has funded scholarships to train Category II (i.e. technically trained without a university degree) prosthetist-orthotists at accredited P&O training programs. 3 One such program is the Cambodian School of Prosthetics and Orthotics (CSPO) ran by Exceed.

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OTHER - National Committees and Meetings

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My numerous and varied work experiences have provided me with excellent foundational skills, which I now hope to apply to the realm of public health. As a clinician at the University of California San Francisco (UCSF), I provided patient care, which involved troubleshooting, patient education and management, documentation, and billing. Additionally, I served as the P&O resident research mentor, providing individualized support and training in research methodologies.

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Strategic Analysis, Research and Training Center (START)

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International funding through scholarships has increased access to P&O training programs such as CSPO; however, collectively accredited P&O programs worldwide annually graduate fewer than 400 practitioners. Loss of practitioners through attrition from the field likely exacerbates the growing need for trained and skilled P&O practitioners. The extent of the problem of attrition is currently unknown, as employment and retention rates for graduates of P&O schools in Southeast Asia are not reported in the literature. While graduation rates are often deemed a standard of success for educational programs, retention rates are equally as important to ensure a sufficient and sustainable workforce. In addition to documenting attrition rates, the barriers to retention must be explored in order to identify those, which are modifiable. Resources and donor funds can then be allocated most effectively to minimize barriers and promote development of a sustainable, global P&O workforce.

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Thank you for considering my application for the RA position with the Strategic Analysis, Research and Training (START) Center in the Department of Global Health. I am currently a PhD student in Rehabilitation Science and an MPH student in Global Health. Additionally, I have ten years of clinical experience as a certified prosthetist orthotist (CPO), an orthotist mentor in Laos PDR, and have worked in multiple capacities here at UW. I have been a primary instructor, teaching assistant, and research prosthetist in the Prosthetics and Orthotics (P&O) Masters Program.

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Department of Global Health | University of Washington

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Proposal Title: Attrition of Prosthetist-Orthotist Graduates in Low and Middle-Income Countries

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