Short term tutoring visit to the Dominican Republic

on behalf of Physicians for Peace (PfP) – HIPOE program

30.01. – 12.02. 2011
Heinz Trebbin

The visit to the Dominican Republic had the objective to support 13 students in their
preparations for their first semester exams in the end of March 2011. The students undertake
currently their first module of the University Don Bosco (UDB) distance learning program. 10 of
the students come from the “Aociacion Dominicana de Rehablititacion” (ADR), two of them from
the “Patronato CIBAO de Rehabilitacion” and one from Haiti.
The visit was supported and prepared by Physicians for Peace (PfP) and supported by ISPO
under the HIPOE project, which was presented to the USAID/ISPO committee in Nov. 2009.

Both local institutions were well prepared for the visit and showed a strong interest at all aspect
of the ongoing education program. All of the students are highly motivated and are committed to
the studies, which require from same a lot of effort during the self-study periods of the program.
It was notable, that all of them had already improved their abilities to interpret medical
prescriptions and their communications skills with other rehabilitation personal in their centers.
All of them expressed, that they appreciate the program and its content, as well as the
associated study methodologies of the blended learning program. A more detailed impression of
each of the students answers, which were given during an on-site interview, are attached to this
brief report.
Further to the discussions that were held in the Dominican Republic and at a meeting in Costa
Rica on the 14th of February I would like to give some recommendations to prepare the students
and improve their abilities to cope with the ongoing studies.

 The clinical assessment skills of the students should be further strengthened with support
of the rehabilitation personal of the different centers. This should include apart from a
detailed clinical history the testing of muscle strength and range of motion (ROM)
depending of the situation of each patient.
 In this respect it was discussed with Dra. Rosario, the head of physical medicine at ADR
that they would develop a clinical evaluation form for this purpose and introduce it to the
students.
 I recommend, that the students than start to use this form for all future patients that they
are treating and present from time to time case studies at their respective centers. It
would be ideal, if this would take place once every two weeks with the involvement of
other rehabilitation specialists of the centers and the local Cat.II technician, who is
working as an advisor in Santiago.
 For the case presentations the students should use a PPT presentation, in which they
present the patient and their findings and based on them their objectives and orthotic or
prosthetic treatment.
 Each student received during the recent visit a PPT presentation of an example of an
Orthotic and a Prosthetic case as a guideline to prepare their cases.
 A first presentation of this kind could be prepared by each student during the following
weeks and be presented during the visit of the PfP group in March 2011.
 The students have to strengthen in general their ability to define and defend their
treatment goals, based on the clinical and personal data they gather during the patient
evaluation process.
 Not all students started their study with module 1 (lower extremity prosthetics), because
some were chosen to undertake orthotic studies only. This led to a lack of some of the
basic information given in module 1 (Anatomy and Biomechanics) and it is therefore
recommended, that these students don’t undertake their examinations in the end of
March, but together with the group that is taken now module 1 and which will start
module two in the end of April. This gives them a chance to compensate the missing
information and to be prepared adequately.

I would like to thank PfP and ISPO for their preparations and support to make this visit
possible. I would also like to thank all the people and the ground for their time and support,
as well as each student for their efforts to make this a very positive and useful experience for
me.

Heinz Trebbin