RESNA 26th International Annual Confence
It is not always realistic to assume that a Rehabilitation Engineer trained in service delivery will be able to stay in that particular area of the field. When evaluating different educational models, it is important to also consider secondary benefits to students. A survey of past and present interns of the University of Michigan Rehabilitation Engineering Program shows that a clinical internship provides graduates with many skills that are transferable to many types of jobs.
The growing field of assistive technology has led to investigations into the development of training programs for assistive technology providers (1, 2, 3, 4). Although perhaps desirable, it is rarely practical to train a person to work in one specific area of assistive technology. Even within rehabilitation engineering, an individual may work in various settings (i.e. clinical, research, or industry), areas of assistive technology (i.e. computer access, seating and mobility, environmental control, or augmentative communication) and funding situations (insurance reimbursement, company research and development funds, or university grants)(5). Due to funding considerations, limited resources, and the need for breadth, it is neither possible nor necessarily desirable to establish separate programs for each potential area of specialization.
In addition, people are often hesitant to choose an educational path that prepares them only for a narrow range of jobs. For many reasons including pay scale, availability of jobs, and geographical preferences, people often work in jobs that do not directly match their training. Today's society requires flexibility in skills and our investigation of training programs should consider this.
This paper looks at the secondary benefits of a clinical internship in Rehabilitation Engineering as identified by a survey of current and past interns of the University of Michigan Rehabilitation Engineering Program (UMREP). The current internship, which consists of a minimum of 20 hours of work per week for 20-24 months, was detailed in a previous paper (1).
To date, 50 individuals have completed a clinical internship through the UMREP (38 completing more than one year). Contact information was available for 3 current interns and 14 graduates. Of those, the 3 current interns and 7 of the graduates responded to general questions regarding their view of the internship's secondary benefits. These responses were followed-up with individualized interviews conducted by email, in person, and over the phone. Questions included original reasons for choosing the internship, career path before and after the internship, and specific transferable skills gained from the internship. The graduates who responded now work in a wide range of jobs: clinical services, industry, academic research, and management.
Those surveyed indicated that internships are valuable because they help a person to move from the theoretical world of the textbook and the classroom, to the practical use of concepts and ideas in real life situations. Although the specific development of each person during the course of an internship varies, recurring themes emphasized by the interns surveyed fall into four major categories: disability awareness, teamwork, technical skills, and personal development.
People working in areas related to assisitive technology have not always had exposure to people with disabilities. In industry and research, typically there are few opportunities to gain increased contact with people with disabilities. Without an understanding of the target clientele, it is much more difficult to develop relevant technology. Although some difficulties may be prevented through standard market research techniques, interviewing individuals with disabilities often intimidates people at first, particularly if personal questions are involved.
In a clinical environment, any fears of this nature are challenged through daily interactions with people with varying backgrounds and disabilities. Engineers learn how to work in conjunction with the people their work impacts, instead of developing solutions that are disconnected from actual needs and desires. The interns surveyed felt that this is an extremely effective way to heighten one's awareness of the needs, desires, and concerns of various people with disabilities. Not only is this awareness critical for those developing technology, it is essential for every person to learn.
The UMREP works closely with other members of the hospital's rehabilitation team (physicians, therapists, families, and patients) to coordinate a holistic rehabilitation plan. Interns must learn both to act independently, and to understand how they fit into the context of new and previously formed teams. Several past interns emphasized the value of this part of the internship, as superior teamwork skills are extremely valuable in almost any job.
In order to work effectively and confidently with other medical professionals, interns also need to develop excellent communication skills. This includes understanding what other specialists are trying to accomplish, communicating the rehabilitation engineering goals effectively, and proposing areas of possible collaboration. These are valuable skills for anyone. In particular, the medical setting is useful for those who wish to go into the medical device industry as it develops an ability to use medical terminology in written and oral communication.
Working in a clinical internship gives engineers an opportunity to see the discrepancy between products on the market, and the needs of their clients. They have a chance to try to reduce this gap by integrating commercial systems, or making custom designs and modifications. This process gives interns an opportunity to put into practice their technical training and problem solving skills. The practical side of using tools, understanding different materials, predicting areas of fatigue, configuring interfacing electronic systems, and designing technology for acceptance are essential skills for an engineer.
Due to the clinical nature of the internship, students are exposed to many different types of devices and different situations in which they are used. This allows for a much wider base of experience than can typically be obtained from an engineering class design project or from working on a single product in industry or research lab. Once the engineer has obtained these skills, past interns have found that they are then easily transferable to all areas of engineering.
Interns at the UMREP are expected to work directly with clients in order to meet their needs and are given cases to manage independently during the later stages of their internship. The direct interaction, forces a person to take complete responsibility for his or her work. Interns deal directly with a client's disappointment and/or satisfaction giving them an understanding of the impact of the services they provide. Those surveyed feel that this increases a person's dedication to the field and desire to provide the best work possible. Thus, many of the past interns who have not stayed with clinical work have continued to work for excellence in assistive technology and related fields.
In the course of working with a client, it is not unusual for interns to come across problems, which they do not know how to approach. While this can be uncomfortable, especially if a client or another member of the rehabilitation team is present at the time, many interns consider this experience to be very valuable. Being faced with the unfamiliar teaches a person to confidently discuss less well known areas with clients, ask for help, formulate appropriate questions, brainstorm possible solutions, and ultimately decide how to approach a previous unknown.
Although the primary purpose of the UMREP clinical internship is to train rehabilitation engineers in service delivery, a survey of past and present interns of the UMREP reveals many secondary benefits. In addition to continuing in direct service delivery, graduates of this program have also gone on to pursue Ph.D. degrees with a focus in rehabilitation engineering, work in assistive technology and bioengineering-related industry, study rehabilitation medicine, teach courses in rehabilitation engineering, and perform rehabilitation-related research. Based on their experiences, those surveyed expressed four major areas in which they gained valuable transferable skills from the clinical internship: disability awareness, teamwork, technical skills, and personal development.
University of Michigan Rehabilitation Engineering Program
1C335-0032 UM Hospital
Ann Arbor, MI 48109-0032