Rehabilitation Engineering is not a profession. Does this statement raise your hackles? It does mine. But what do I mean by this? There are several hundred engineers in this organization who consider themselves 'rehabilitation engineers'. Many of these have job titles and job descriptions which say 'Rehab. Engineer', and which correspond to accepted notions of what constitutes a rehabilitation engineer. There are also many non-engineers who have jobs with comparable job duties to the 'rehabilitation engineers', and who have similar levels of experience, who call themselves 'rehabilitation engineers'. Are they both 'rehabilitation engineers'? Some 'rehab. engineers' are licensed professional engineers who have limited rehabilitation experience, but who are hired to fill the role of rehabilitation engineer by agencies and organizations. Some are non-engineers with 25 years experience working as members of rehabilitation teams. Most have some mixture of training and experience that has led them to this professional arena. Are they all rehab. engineers? Why, or why not? Where would you trust them to work: circuit riding, with limited direct therapy support; in a comprehensive facility; in product development? Are there others who can fill these roles? What in the hell is a rehabilitation engineer anyway, and how does one fit into the spectrum of allied health service providers?
We all have opinions regarding these questions. We have a definition written into the current edition of the Rehabilitation Act. We even have a couple of versions of a knowledge, skills, and abilities list, purporting to describe what rehab. engineers need to know. Unfortunately, each opinion is unique to some extent, our Rehab. Act definition is more legalistic than functional, and no list of KSA's can tap into the core of what all of the different job situations require of rehab. engineers. Just think; if we cannot define for ourselves who we are as professionals, and where we fit into the service delivery picture, how can we expect people outside our group to understand us, much less fund us through insurance? That is what I mean when I say rehabilitation engineering is not a profession.
One result of this ill-defined situation is the current controversy surrounding certification for rehab. engineers. For the past ten years we have heard forceful arguments on all sides of the question of what we should require of future rehab. engineers in order to certify them in that role: engineer + ATP; engineer + EIT + ATP; engineer + EIT + ATP + Exam; and so on, ad nauseum. Again, we are begging the question of what we really mean by the term 'rehabilitation engineer'. I was an early proponent of certification, and still see the need for such a process. However, I do not now believe that we can certify what we cannot even define adequately. What purpose would certification serve, even if we did somehow reach a consensus on how to certify? Does anyone really believe that Blue Cross/Blue Shield will begin funding rehab. engineering services because the rehab. engineers certify themselves? I believe certification must derive from an essential understanding of the unique place we fill in the allied health professions, as well as from a demand for and commitment to professional standards in the execution of our duties as rehabilitation engineers. In short, certification must be a natural result of the development of rehabilitation engineering as a profession. The converse will certainly not occur.
So, how do we make this happen? I believe it must start with a core group of 'rehabilitation engineers', who are dedicated to seeing this profession develop. We must begin the discussion among ourselves, research the history and experience of other professions, publish our ideas for general consumption and response, and gradually distill those ideas into an implementation plan. I have invited a group of colleagues to begin sorting out ideas with me over the RESNA list serve, so that everyone on the list has an opportunity to see what we have in mind, and submit their own ideas and perspectives. During the course of this year, this group will share ideas through various venues. We will work to compile a history of rehabilitation engineering, a condensed history of professional development for some other professions (occupational therapy, speech/language pathology, for instance), and an outline of an action plan that we believe will succeed in establishing rehab. engineering as an established and important profession within the allied health field. As we develop information to share, I intend for it to be disseminated as widely as possible, so there is no implication of elitism or backroom politics. While I want to keep the group small and close-knit, I invite anyone to ask questions, offer suggestions, carp, or otherwise keep in touch during the year to help us better refine what we are trying to do.
So, how do we make this happen? I believe it must start with a core group of 'rehabilitation engineers', who are dedicated to seeing this profession develop. We must begin the discussion among ourselves, research the history and experience of other professions, publish our ideas for general consumption and response, and gradually distill those ideas into an implementation plan. I have invited a group of colleagues to begin sorting out ideas with me over the RESNA list serve, so that everyone on the list has an opportunity to see what we have in mind, and submit their own ideas and perspectives. During the course of this year, this group will share ideas through various venues. We will work to compile a history of rehabilitation engineering, a condensed history of professional development for some other professions (occupational therapy, speech/language pathology, for instance), and an outline of an action plan that we believe will succeed in establishing rehab. engineering as an established and important profession within the allied health field. As we develop information to share, I intend for it to be disseminated as widely as possible, so there is no implication of elitism or backroom politics. While I want to keep the group small and close-knit, I invite anyone to ask questions, offer suggestions, carp, or otherwise keep in touch during the year to help us better refine what we are trying to do.
I want to start on two fronts at once. First, I have contacted Aimee Luebben and Jim Lenker for perspective on the occupational therapy side. Aimee has promised to send me information on the history of the development of OT as a profession. I did the same with Carolyn Watkins in Speech/language Pathology. Other contacts or sources of information would be greatly appreciated. Second, I want to begin the discussion of rehab. engineering as a profession by asking the question, "What is a rehab. engineer, relative to the delivery of services to people with disabilities?" I pose the question in this manner because this is the crucial issue. While the engineers and scientists in academia and product development are crucial to the continued development of technology, they are not affected by issues of rehabilitation team dynamics, funding, certification, or other service delivery issues. Likewise, they do not directly impact the appropriateness or inappropriateness of the technology that is prescribed for people with disabilities. It is essential, in my mind, that we focus on defining our profession in terms that affect the public weal, since that will be the only impetus that creates a general recognition of the need and purpose for our services.
I am counting on the group that I spoke with at the conference to begin responding. Our president-elect has expressed support for this effort, as has the new chairman of our PSG. I think it is time that we focussed our vision on who we are, and where we wish to go in the future.
Ed Irwin
Rehabilitation Engineer
Mercer Engineering Research Center
Warner Robins, GA