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I-'AGE I.,.,H I ~::rLl:SLLbt:Ha,j 08/27 DESCRIPTION OF THE RESIDENCY PROGRAM Provide answers ano/or deSCrlotiolls 10 the folloWing QUGStions on th...

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I-'AGE

I.,.,H

I ~::rLl:SLLbt:Ha,j

08/27

DESCRIPTION OF THE RESIDENCY PROGRAM Provide answers ano/or deSCrlotiolls 10 the folloWing QUGStions on the proposed residem:)! program. 1. How many resident.<; have completed your program in tile past five years?

J

6. First application for residency accrool1ation

2. Do you have a university affiliation?

0

Yes

0 0

Residents Completed:

I).

Orthotic: _~_ C. PrO$thetic: __________

No

If yes, Identify: _ _ _~~__ 3. Identify planned seminars/education exper'll~nces for the resident:

o Cllnlcallec1ures 0

~

121

Grand Rounds ReglonailState Academy Meetings

0

mLocal SemJnaffl.

0

0 0

[{] Manufacturing Workshops National O&P Meetings Other: _ _ _ _ _~_________~_ _~_~_

4. Which of the following and hOw many will assist as staff for the rt!slden;y program?

J5.

d. Administration: 3

jQ

g. Certified Filters:

~ h. Certified CPed.: _~_ __

1

e. Clinicians:

%_-,-'P ___

f. Techniolaos:

2

-~---

What Is/Will be the resident app!lca~on process?

L Does the program have written selection procedures, including admission eligibility criteria to provide residents?

.0 Yes

ONa

If no, provide explanation: _--:__--:'"""""'":""_ _ _-:--:-:-_ _ _:-:-_~______:_~---~--Submit with application a copy of the selection pmcedure/admlsslOl1 to residency program and the Residant Agreement.

(Reference Standards 3.2 and 3.3)

J. Do you require submission of a resume with cover letter? 0Ves 0 No k. Do you perform an on -site interview? 0Yea 0 No I. Do you perform aphone interview? 0ves 0 No If yes, what is me date? _ _ __ Dyes 12) No m. Do you have a set calendar day oy which aU residents must apply? n. Will the residency site pay the resident fea? 0Yes 0 No o. What are the transportation requirsment(s) of the residents to participate at tM proposed residency program?

J J

they must provide their own transportation

p. 00 you (equire the residents to sign a non-compete contract?

0

Yas [2] No

q. Will there be times when aresident is sUDerviseo directly via live video, web cam, or by other means ot live vlsuai technology? In spaCk! below provide detail.

No r. In space below provide The Program's Mission Statement. Please attach additional pages if naeded. THE PROGRAM MUST HAVE AMISSION STATEMENT THAT DESCRIBES THE OVERALL PURPOSE(S) OF THE RESIDENCY PROGRAM

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s. In 6pace below provide any additional information on the application process of residents for the proposed program:

NCOPE APPLICATION FOR ACCREDITATION OF RESIDENCY PROGRAM

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Orthopedic Motion, Inc..

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Providing State-of-the-Art Orthotics and prosthetics ~ lacO E.

De,erllnn 1'\02(1

Suit'" 250 lilS VE;!gas. NV 8S1,1 1': 702.697.7070

r.: 702.697.7077

32331.''1,

CharIGS~';)I!

Blvc.

$vi~,) ~ 11

L~, vea<>s. NV 89102 P: 70Z.{i:r, ,;'070 1'; 702,G97.7cm

La, \Ie;:as, Nv &:l14& ~: 702/~M,7500

F:

f02489.7.~C4

MISSION STATEMENT

Orthopedic Motion, Inc. is devoted to developing human potential.

Our mission is to help people create innovative solutions and make informed choices to improve their lives. We motivate and encourage others to achieve their own personal and professional fulfillment.

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Orthopedic Motion, Inc. Providing State-of-the-Art Orthotics and Prosthetics :2800 ". D<1~~r, In" Road

Suite 250 L.!. V!!g~$. NV 89121

1'; 702.597.7070 F: 702.697.70'I!

3233 IN. (~hc.lrlestoll Bh.ld. Sqll!! Hi ,"", Ve!\
8~~O

w.

Sun;~\ Ro~"

S•.';'" 340

las veG"~' NV 2.9:t4a ~;

701.489.7500

~;

702.41\9.7504

Selection Process

• Residency Selection Committee consists of! residency director and clinical mentor • Application materials should include the following: • Letwr of interest that included the ~ppljcant's goals

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residency

• CUrrent curriculum vitae • Two letters of reference (those c:an be sent by the refel'ence directly to our program 01' the letters can be included by applicants with their application materials) • Work Experience and Internships should be included. whether paid or volunteer work • All applications are initially screened by members of the Residency Selection Committee, who look for students with the potential to become leaders in the field. Once the initial application screening process has been completed, 2-3 applicants per disciplille will be selected for phone interviews. • The tinal selection process from among tbe interviewed applicantS will be based on the candidate'S ru:ademic credentials, work e~perience~ and personal attributes including work ethic, enthusiasm. Inotivatioll, communication skills, willingness to be a team-player, and integrity displayed at the time ofthe interview, Those qualified applica11tS will then be tanked and ultimlltely 1 applicllJlt per discipline will be: selected by the selection ~otnmjttee. • The selected individuals will be notified of their selection and t.he\} they will start new hire soreening !.\110 application process,

• All applicants not accepted will be [lotificd concerning their status • Selection is not based 011 race, etJ1I1icity, sex, religion, creed, national Origi11, age, sexual orientation, or physical disahility,

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I-'AGE

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DESCRIPTION OF THE RESIDENCY PROGRAM conI. Provide answers and/or descriptions to the following Questions on me proposed msidency program. 6. What is the eltpected percentage of time 5P€mt by the resident in the following areas of the practice: 60 _ 01. _ q. Clinical: r.

J ~3~O

Fabrication:

s. Practice

man~ment

lime spenlln tile line areas ~ should be a combined of 100% :.(l "l~:i;' ®,.

_ _ _%

%

10

(administrative):

~)

~~f(J

,eta.

100%

7. Identify the percentage of time in the specific seillng thai direct patient care Is provided by tfle practice:

Setting Primary facility:

J

Affiliate facility: Specialty clinic::

Orthotics 50

-~-~

25

% %

-~~_%

(e. (J" neuromuscular, cerebral ~Isy, spina bffidJ)

settings for

each disclplne should bu "­

combined total.

of 100%

_1_5_~_%

Acute care hospital setting:

% /

50

_ _ _ _%

_2~

_15_ _..... _% 10 %

_ 10 _ _ _rJI10

long-term rehabilitation Facility: (e.g., nursing IlOme. Assisted living facility)

Prosthetics

Other facility:

---_% 100% 8. Identify the percentage of devices fabricated on-site at the residency site and OUTsourced to central:

*

Fabricated

Onsite: Outsourced:

Orthotic ~90~_ _ _% 10 %

% 100%

Prosthetic

).-

_90_~_% _10 _ _ _ _%

9. Identify the percentage of devices which incorporates the use of CAD/CAM in the practic0.

Orthotic %

Pros1t1etlc Upper 11mb 0

_.~ %

10

%

LoWer limb 0

%

10

%

Upper limb

0

Lower limb Spinal

Cranial Facial 100

%

10. Does this practice parr1clpate In any specialty clinic affiliations? Gneck all That apply:

o Management of spine o Spine (post-operative) o Brain InjuI'J

FREQUEN::;V

o Burns o Scoliosis o o o o o

Dlabetlc/Neuropathlc foot OSpina Blflda 2 x times a month

Veterans Indigent care outreach MSClinlcs Shrlners Hospital Identify specialty clinics not lIsted:

o CPClinic

FREQUENCY

o Wound Care o Muscular Dystrophy ttl Pediatric Orthopedic o HandClinic o Amputee Clinic o Sports Medicine

o Pedorthotlc o Gait o Cranial Facial o Upper

contInues» NCOPE APPlICATIOtl FOR ACCR8)ITATION OF RESIDENCY PROGRAM

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DESCRIPTION OF THE RESIDENCY PROGRAM conI. Provioe answers and/or descriptions to the following questions on the proposed residency progr31Tt

~

11. Will the resident have the opportunity to observe surgiCal procedures? [2] Yes

0

No

12. Are you able to accommodate a resl
j

IZl Yes 0

No

Are you able to accommodate aresident cOilsldering aResearch and Development residency track experience? j 13. (Reference Standard 2.6.2)

0 Yes 0

No

14. Please identify types of acrJvides you anticipate a"Clinical Track" resident can complete from Ihe checklist below. (must choose at least three actlvities to Qualify)

0' Critically Assessed Topic (CAT)

IZI Joumal Club nresentation

[2] Professionallnrservlce

[2] Presentation at grand rounds, stale, regional, natiOnal or international meeting

(2] Case Presentation

CRITICALLV ASSESSED (APPRAISED) TOPIC (CAl) • ACAT Is a \}r~f summary cf the most currently pui)rtSMd rssearet'l (hal is lISed to answer aspectftc clinical question. rtle author deftileS the scope 01 the CAl based (.In his/:ler KnOYiiadge of lh" topic and resaarch at hand. The CAT Is abrief Cluie!!1 apllmlsal of the literature. It may be used to inf(llTn cllnlCIII prac:tiGB as a seconaary kIlowledge source. CASE PRESENTATION - A case study I)reJ!anlatlon given to colleagues wifuin IhB residency program. A ca6e s[uay Invc/V
int~ntiOl1 of incraesinQ the

,

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15. Please IdentIfy types of directed studies you anticipate a"Research and DBvelopment Track" resident to complete from the checklist below.

I:2J Literature

Review

0

Case Study Involving Human Subjects

o Scientific Studv Supervised by a Qualified Research Orgal1iz81ion

ill Scientific Study [2] Other Study

FOR MORE INFORMAT10N ON DIRECTED STUDY GO TO WWW.NCOPE.ORG.

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NCOPE APPLICATiON FOR ACCREDITATION OF RESIDENCY PROGRAM

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DESCRIPTION OF THE RESIDENCY PROGRAM cont. Provide ail$lfJSrS and/or t1escriptions to ti)L1 following Questloos on the proposed residency program.

16. Identi~J all resources available for the resident to perform !Ilelr directed study:

a.lrnemet accessibility [2]

b. University library [{I c. In~11ouse library II]

J

d. AslBase time to complere stuoy e, Instrumentation/specially eQuipment on-site

1. Access to off si1e specialty equipment, i,e., Qait lab

IZJ IZJ 0

Please list any additional resourCes not Ilsted:

MCOPE APPlJCATION FOR ACCREDITATION OF RESIDENCY PROGRAM

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