Manual Wheelchairs - World Health Organization

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Table 4.2. Clinical and technical competences at basic, intermediate and advanced levels of wheelchair service delivery Service delivery level Clinical role Technical role Basic Able to carry out basic user assessment, prescription, fitting and follow-up for users with basic needs (not requiring modifications or postural support). Able to identify and refer users who require wheelchair modifications and postural support; able to follow up these users once they are provided with a wheelchair. Able to carry out basic training in wheelchair provision for referral network personnel. Able to keep records of individual users (case files). Intermediate Able to carry out user assessment, prescription, fitting and follow-up for users requiring basic wheelchairs, wheelchairs with modifications, and wheelchairs with postural support. Able to identify users who require complex seating; able to follow up these users once they are provided with a wheelchair. Able to carry out training in wheelchair provision for referral network personnel. Able to train, supervise and support clinical personnel in basic wheelchair provision. Able to keep records of individual users (case files). Advanced Able to lead the service team in wheelchair provision for all users, including those with the most complex need. Able to work with a high level of professionalism, including record keeping, service development and supervision of less qualified personnel. Able to develop and deliver training for clinical wheelchair service personnel at all levels. Able to participate in team assessment, prescription, fitting and follow-up of users with basic needs. Able to assemble or set up manual wheelchairs according to the manufacturer’s instructions and prescribed components (without modification). Able to carry out modifications of some wheelchair or postural components as directed by the supervisor. traInIng I 105 Able to participate in team assessment, prescription, fitting and follow-up of users requiring basic wheelchairs, wheelchairs with modifications, and wheelchairs with postural support. Able to assemble and set up manual wheelchairs, including the design and production or assembly of modifications to meet prescribed needs. Able to carry out basic training in wheelchair provision for referral network personnel. Able to train, supervise and support technical personnel in basic wheelchair provision. Able to carry out a full assessment of user needs, either independently or as a member of the service team. Able to identify appropriate commercial products or to design and make custom products to meet the needs of all users, including those with the most complex needs. Able to work with a high level of professionalism, including record keeping, research and development, quality control and supervision of service workshop and technicians. Able to develop and deliver training for technical wheelchair service personnel at all levels. 4
106 I guIdelInes on the provIsIon of manual wheelchaIrs In less resourced settIngs 4.2.3 Trainers Training programme development Trainers working in wheelchair service delivery require knowledge of different impairments and chronic conditions. They need to understand who can benefit from using a wheelchair and which wheelchair model and features are most suitable for an individual. Also, they need a clear understanding of how to prevent further deformities and complications, and a broad understanding of disability in general and environmental factors. Trainers also require skills in wheelchair use, effective communication and training, and knowledge of the rights of persons with disabilities. Users and delivery of training Active users may effectively teach wheelchair mobility skills and transferral, demonstrating what an actual user can do. Users may also be able to explain to trainees what it was like when they first received a wheelchair, and what training or instruction they found most beneficial or would have found most beneficial had it been available. Box 4.5. Wheelchair service delivery training in Africa Abdullah Munish had a spinal cord injury due to a car accident in 2000. He was in the Kilimanjaro Christian Medical Centre in the United republic of Tanzania for nearly eight months. It was a very frustrating time for him as he learnt that he would not be able to walk again – it was almost like the end of the world for him. From his therapists, he heard of a training opportunity for him to become a wheelchair technologist. This gave him a ray of hope. With the help of his therapists and supporters, he joined the one-year Wheelchair Technologists Training Course at the Tanzanian Training Centre for Orthopaedic Technologists (TATCOT). The course, which is accredited by the International Society for Prosthetics and Orthotics, teaches the technical skills of wheelchair production as well as anatomy and physiology, the pathology of different impairments, technical drawing, workshop management and disability studies. This enabled Abdullah to build on his production skills and learn how to assess people and prescribe them with the right wheelchair, as well as the essential management skills needed to run a small business. Abdullah has said of the course “I had no idea there was so much to learn about wheelchair production and distribution. now I can produce good quality wheelchairs, but I can also ensure that a wheelchair is right for the person using it. The more you learn, the more you realize that the provision of wheelchairs is a complex subject and we need to continuously develop our skills and extend our knowledge. We need more knowledge in supportive seating, for example, and to continuously improving our designs and our services.” Abdullah finished the course in 2001 and was employed as a wheelchair technologist by the Kilimanjaro Christian Medical Centre. His first challenge was to set up a wheelchair workshop at the hospital, which took nearly a year to complete. Since then, he and his colleagues have been producing appropriate wheelchairs and providing services to people living in the Kilimanjaro region. Abdullah teaches wheelchair skills and disability issues to students at TATCOT and at a college for occupational therapists. At the Kilimanjaro Association of the Spinally Injured, he gives training to others as a peer trainer. Abdullah has also been a guest lecturer in wheelchair design for developing countries at the Massachusetts Institute of Technology in the United States.
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Manual Wheelchairs - World Health Organization

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