The British Casting Certificate
(formerly known as the BOA/RCN (SOTN) AOT Casting Techniques
Certificate) has been the only nationally recognised qualification in
Casting for the last 24 years for both the Orthopaedic Technician and
Nurses whose role includes Casting and Splinting. The certificate and
training courses are recognised internationally and this is reflected by
the continuing application to courses by students from abroad. As well as the original five-week block courses (now three and sometimes four per year) running at The Royal National
Orthopaedic Hospital, there are in addition regional day release
courses in a variety of locations around the UK providing this vital
education.
The practical nature of the Course means that
places are limited and necessarily more costly than would be the case
for a mainly theoretical Course. As a prerequisite you must have a
minimum of 1 year of experience in casting application. Applications
must be supported by a recommendation from a Consultant Orthopaedic
Surgeon, who is a Fellow of the British Orthopaedic Association, and
from your Line Manager. Nursing staff, casting room technicians and
others who need to become expert in practical casting techniques are all
equally welcome.
Prior to attending the Course, it is a requirement for candidates to study the theory as shown in the Syllabus.
Contents
The Role of the Orthopaedic Technician/Casting Room Nurse
The qualified Orthopaedic Technician/Casting Room Nurse is a vital member of the healthcare team providing a service not just in Orthopaedics and Trauma but also Trust-wide across many different specialties. In a similar way to Orthotists and Physiotherapists, they interpret prescriptions from a wider multidisciplinary team, being able to discuss issues of care with other relevant Healthcare Professionals. Orthopaedic Technicians/Casting Room Nurses assess, plan, implement and evaluate care episodes using, wherever possible, evidence-based practice. They have a wide knowledge of commercially available products and will choose appropriately, both for efficacy and cost effectiveness using evidence and auditing their practice on the description of their role in the above, it can be seen that Orthopaedic Technicians/Casting Room Nurses have to practise autonomously and have a very definite potential for harm to the patient if they do not exercise good clinical judgement. Some of the complications that can arise are:
- Circulatory impairment, including Compartment Syndrome.
- Nerve impairment caused by poorly applied cast or as part of the circulatory impairment.
- Long-term problems for the patient from either incorrect position of the fractured limb, incorrect position of the cast or an incorrect cast being applied.
- Pressure sores inside the cast due to incorrect/poor casting techniques or patient intervention (i.e. foreign objects inside the cast) resulting from lack of proper instruction to the patient.
- Stiffness of joints due to incorrect extent of the cast obstructing movement of the adjacent joint(s) or lack of instruction to the patient regarding specific appropriate exercises, although, obviously, joints held within a cast may get stiff.
- Allergic reaction to cast materials if the Orthopaedic Technician fails to assess the patient fully prior to treatment or fails to recognise the symptoms when an allergic reaction occurs.
- Many cases of litigation relate to cast removal and to poor use of the electric cast saw. These result in burns and cuts, which can cause serious scarring.
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Glasgow Caledonian University
From September 2011 the Qualification will be Validated and the course students assessed.
A total of 60 credits at University Diploma Level will be awarded by Glasgow Caledonian University to students who satisfactorily complete the course (theory, simulated practice and clinical practice) and attain a pass in each of the assessments. The assessments comprise a theoretical component (3000 words) and an Objectively Structured Clinical Examinations (OSCE). The course fee includes this accreditation.
Who are the Instructors?
The instructors on the Course are chosen from orthopaedic surgeons, orthopaedic nurses/tutors and nurses and/or technicians specialising in casting techniques.
Course Content
Theory - Teaching is given in anatomy and physiology. There is a wide subject matter relating to trauma and orthopaedic conditions. This theoretical knowledge is linked to practical patient care. In addition, health and safety, legal aspects, documentation and much more are covered.
Practical - The emphasis is on “hands on” practical sessions and the Courses are kept small in order to provide a very high instructor/student ratio. In this way, participants on the Course can build rapidly on their previous casting room experience. The aim is to perfect existing skills, learn new and alternative methods and be able to discuss and critique work in a constructive way.
What materials are used? - Most cast application techniques are taught in resin-based materials and plaster of Paris. Participants will have experience with a full range of modern materials and will learn how to use their special properties for particular applications.
Worshipful Company of Barber Surgeons
Each year the Worshipful Company of Barber Surgeons generously supports one Course place which is awarded to a candidate who can prove that he/she has been unsuccessful in obtaining funding. This award is only open to United Kingdom Citizens who work in the UK. If you require further information about this Award please contact Casting Course Coordinator at the British Orthopaedic Association on 020 7405 6507.
Members of the Association of Orthopaedic Practitioners may apply directly for help with funding.
The Examination
The Course is followed by an examination. The examination fee is included in the fee for the Course. The object of the examination is to give casting room staff the opportunity to prove that they have reached a high standard of safety and competence in treating patients. The British Casting Certificate is awarded to successful candidates and is being increasingly recognised by employing authorities and gives added support when responsible posts are being considered. British Casting Certificate holder’s names are held on a Register at the BOA and must recertify every 3 years and provide evidence of Continuing Professional Development to stay on the Register.
From 1st January 2006 the examination is no longer available to those who have not previously attended a BOA Committee Validated Course.
CRITERIA FOR ENTRANCE TO:
Attend an approved course and examination At least 1 Year’s experience in casting application, sufficient theoretical knowledge and experience in caring for in patients and outpatients with trauma and orthopaedic conditions, see below
Attend the examination only Previous attendance at a BOA Committee, Validated Full Casting Course. All retakes of this Examination must be completed within 2 years of course attendance.
A Fellow of the BOA and your Line Manager MUST validate this information, and must also certify that the candidate has, in their opinion, sufficient experience in:
1. casting techniques
2. the care of inpatients and outpatients with orthopaedic conditions and trauma
3. sufficient theoretical knowledge,
to enable him/her to enter the examination relevant to the published syllabus.
Under certain circumstances, the Casting Techniques Subcommittee may allow a candidate to take the course and examination without the full prerequisite experience. In this situation, if successful, the candidate would have their certificate withheld until they have achieved the length of experience required and had this verified by their sponsoring BOA Fellow and line manager.
The examination consists of viva and practical sessions.
All sections must be passed individually and at the same sitting.
There will be two external examiners.
Recommended Reference Books
Additional Learning Aids
Eye Witness Video Productions Tel: 01453 884800
PO Box 141 Email:VMJ@eyewitnessvideo.co.uk
Stroud
Gloucester GL6 9YJ
BOA Library Cat no 524/613
CD of Casting Upper/ Lower Limb
S. Miles; L. Barr
Available in other formats.
Other videos available Department of Orthopaedic and Trauma Surgery Tel: 01382 496278
Wards 18/19
Distance
Learning Section
Ninewells Hospital & Medical School
Dundee DD1 9SY
Distance Learning Modules available. Most of the manufacturing companies produce their own teaching aids - contact the individual companies for more information.
Travel Information
Royal National Orthopaedic Hospital NHS Trust [RNOH], Brockley Hill Stanmore, Middlesex
HA7 4LP
Bus to the RNOH from:
Watford via 142 bus to the Vine Public House [Stanmore Hill]
Edgware via 107 bus to the top of Brockley Hill
Stanmore via 142 bus from Stanmore Broadway to the Vine Public House [Stanmore Hill]
Underground to Stanmore from:
London -Stanmore station (Jubilee Line)
30 minute, uphill walk or taxi (taxis available outside the tube station)
Edgware station (Northern Line)
Catch 107 bus from stop F at bus station to hospital gates
Elstron- (Thameslink)
Catch 107 bus to hospital gates
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Hospital Minibus
The RNOH provides a minibus shuttle service for patients and visitors. This service runs both to and from the Stanmore site to both Edgware bus and tube station (Northern Line) and Stanmore tube station (Jubilee line). The minibus has a large number of pickup points on the site including Orthotics, Outpatients and the Main Gate. This popular service is provided by Barnet PCT on behalf of the hospital from Monday to Friday, commencing at 6.30am and terminating at 5pm. (N.B. Lunch break is between 12.30-13.30, there will be no service during this time).
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