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To explore barriers and facilitators to social and community participation experienced by people following traumatic lower limb amputation (LLA). An exploratory qualitative study was conducted with nine adults with traumatic LLA in Victoria, Australia. Participants were a minimum of 18 months post amputation. Interview data was analysed using thematic analysis. Participants referenced the inaccessibility of the built environment and physical challenges associated with prosthetic mobility as barriers to participation. Chronic and complex health concerns due to their injuries resulted in physical and emotional distress for some, further limiting their social and community engagement. Participants highlighted the benefit of peer-support networks and the value of supportive community groups in assisting the transition to their pre-amputation family, work and social roles. Participants also felt that a strong, positive attitude and being self-motivated were important to aid in their return to social and community participation. People following traumatic LLA experience a number of physical, psychological and environmental challenges to participation. The role of peer-support networks, community groups and personal attitudes are important facilitators to assist a return to family, work and life roles. The findings of this study have informed the development of recommendations to guide clinical practice. Peer-support groups for people following traumatic lower limb amputation (LLA) may assist to improve their long-term adjustment to disability and community participation Retraining skills in an individual's own community should be considered when planning community-based therapy services for people following traumatic LLA. Ongoing psychosocial support including strategies to develop self-efficacy and positive mindset may improve social and community participation Regular medical and allied health reviews can be beneficial to promote early intervention for any complications that arise to minimise time off prosthesis. [ABSTRACT FROM AUTHOR]

We examined the validity of the reported link between well-being and leisure participation in adolescents. Nine hundred and forty-seven, Year 10 students from 19 schools in Adelaide, South Australia, were recruited. Participants completed a questionnaire concerning participation in social, non-social and unstructured leisure activities as well as measures of personality. As expected, personality variables were better predictors of adolescent well-being than spare-time use, although engagement in less structured leisure activities was associated with poorer psychological well-being and substance use. These findings support previous personality research which suggests that spare-time use may be related to well-being only insofar as individuals who are psychologically healthy tend to be involved in structured leisure activities. The implications of these findings for school policy and future research concerning the links between leisure involvement and psychological well-being are discussed. (Contains 7 tables.)

Research indicates that an important determinant of mental health is the degree to which someone feels connected to his or her environment. For young people, how they feel about "fitting in" at school, in terms of peers, staff and the curriculum, is an important factor in their wellbeing. An effective whole school mental health promotion approach will therefore involve the creation of a school environment that encourages a sense of belonging and connection for its students. While the theory behind student connection to school has received a significant level of attention in the education, health and crime prevention literature, not so much is known about how school staff understand the process of "students connecting to school" and what they do to enable it. Even less is reported about the experiences and views of students with high mental health support needs themselves on the issue (see Unheard Voices, Holdsworth & Blanchard, 2005). Therefore, the following study was conducted to seek understanding of the perspectives of school staff about how students connect to school and the implications for enabling the connection of students with high mental health support needs. Qualitative analysis of interviews revealed the emergence of a number of themes that align with previous research on connection to school. This study formed part of the MindMatters Plus initiative, a combined health and education best practice approach to improving the mental health outcomes of secondary school students with high support needs. The findings of this study have practical implications for school staff who are looking for ways to further enable student connection to school. They also add a complementary perspective to those of students as extrapolated in Holdsworth and Blanchard (2005).

This study examined the nature and prevalence of bullying/victimization by peers and teachers reported by 1,284 students (mean age = 15.2 years) drawn from a representative sample of 25 South Australian government and private schools. Students completed a self-report survey containing questions relating to teacher and peer-related bullying, measures of psychosocial adjustment, and personality. The results showed that students could be clearly differentiated according to the type of victimization they had experienced. Students reporting peer victimization typically showed high levels of social alienation, poorer psychological functioning, and poorer self-esteem and self-image. By contrast, victims of teacher victimization were more likely to be rated as less able academically, had less intention to complete school and were more likely to be engaged in high-risk behaviours such as gambling, drug use and under-age drinking. Most bullying was found to occur at school rather than outside school and involved verbal aggression rather than physical harm. Boys were significantly more likely to be bullied than girls, with the highest rates being observed amongst boys attending single-sex government schools. Girls were more likely to be subject to bullying if they attended coeducational private schools. The implications of this work for enhancing school-retention rates and addressing psychological distress amongst adolescent students are discussed.

The aim of the MM+ initiative is to build the capacity of secondary schools to ensure optimal outcomes of students with high needs in the area of mental health. This is important for many reasons including the fact that poor psychological wellbeing in students has been found to lead to behavioural difficulties at school that can then serve as obstacles to learning and further development. Therefore, it is important for schools to focus on supporting students with high mental health needs in order to improve student wellbeing, behaviour and academic potential. The following article discusses the research findings in regard to these relationships. These findings are also examined within a discussion of how schools can help to improve emotional and behavioural problems from within the classroom, including tips about how this was achieved by the MindMatters Plus demonstration schools.

This article examines the literature and the experience of the MindMatters Plus demonstration schools in regard to improving student and staff mental health literacy. The aim of the MindMatters Plus initiative is to build the capacity of secondary schools to increase their support of students with high mental health needs. This is achieved in various ways including the embedding of strategies that support students into the curriculum and ethos of the school, creating processes that effectively identify students at risk, and building community partnerships. A foundation for these strategies is to strengthen staff and student awareness of mental health issues and to create an environment in which students are more willing to seek assistance. This article explores how schools can increase student and staff mental health literacy, and includes examples gained from the experience of the MindMatters Plus demonstration schools.

The aim of the MM+ initiative is to build the capacity of secondary schools to ensure optimal mental health outcomes for all students at risk. This is achieved in a number of ways, including early identification, implementation of preventative and early interventions, refining processes, policies and strategies, and encouraging the development of community partnerships. This article will focus on the latter of these strategies: how schools can further develop partnerships with their local community in order to build their capacity to support student mental health. Research indicates that it is beneficial for schools to work with individuals and agencies in the community, as it can result in more resources and services for students than are possible when schools work alone. This article will outline research in the area of building community partnerships including an examination of the types of partnerships, that can be formed and the issues to be considered. In addition, the article will provide a practical discussion of what the MindMatters Plus demonstration schools have learned as a result of their experience in building community relationships.

This article examines the literature regarding prevention and intervention programs that are aimed at supporting student mental health. It will also examine the practical use of these types of programs in schools, as reflected by the experiences of the MindMatters Plus demonstration schools. The aim of the MindMatters Plus initiative is to build the capacity of secondary schools to increase their support of students with high mental health needs. The implementation of programs that support student mental health is one component of this whole school aim that includes the embedding of a range of strategies to support students with high mental health needs, creating processes that effectively identify students at risk, and the building of community partnerships. As will be demonstrated, the use of intervention and prevention programs in schools can be an effective way of positively supporting student mental health that can be successfully integrated into the school curriculum.

This article describes some key lessons from the MindMatters Plus (MM+) initiative, as a best practice approach to improving the mental health outcomes of secondary school students with high support mental health needs. The MindMatters Plus initiative focuses on early identification of students with mental health needs, implementation of preventative and other interventions, refining processes, policies and strategies to support students at risk, and encouraging the development of community partnerships to enhance the support of student wellbeing. Specifically, this article will examine the key factors that enabled the MindMatters Plus demonstration schools to achieve these outcomes. As part of the initiative, an interview was conducted with staff from each of the 17 MindMatters Plus demonstration schools. Staff members were asked to describe what they had learned as a result of their participation in the initiative and to identify factors that they believed were significant in their ability to improve the support they provided for students at risk. The responses to these interviews, as outlined in the present article, will serve as invaluable guidelines for other schools that want to improve the support they provide for students with high mental health needs.

Objective: Studies of Australian health workforce demographics tend to be limited to single professions, a set geographic area, or based on incomplete data. This study aims to comprehensively describe changes to the demographic characteristics of Australia's regulated health professions over 6 years. Methods: Data were sourced from the Australian Health Practitioner Regulation Agency (Ahpra) registration database, and a retrospective analysis of 15 of the 16 regulated health professions between 1 July 2015 and 30 June 2021 was conducted. Variables including profession, age, gender and state/territory locations for the practitioners' principal places of practice were analysed descriptively and via appropriate statistical tests. Results: Changes in age, gender representation, and place of practice varied significantly and in different ways across the 15 professions. The total number of registered health practitioners increased by 141 161 (22%) from 2016 to 2021. The number of registered health practitioners per 100 000 population increased by 14% from 2016, with considerable variation across the professions. In 2021, women accounted for 76.3% of health practitioners across the 15 health professions, a significant increase of 0.5% points since 2016. Conclusions: Changes to demographics, especially in ageing workforces and feminising professions, can have implications for workforce planning and sustainability. Future research could build on this demographic trend data by investigating causes or undertaking workforce supply or demand modelling. What is known about the topic? Several studies have demonstrated changes in the demography of the Australian health workforce, they tend to focus on individual professions, prescribed geographic areas, or are based on data that are dated or incomplete. What does this paper add? This study presents a national picture of 15 regulated health professions' demographic changes in Australia across a 6-year period and allows for comparisons between professions. What are the implications for practitioners? Future research could build on this demographic trend data by investigating causes or undertaking workforce supply or demand modelling. [ABSTRACT FROM AUTHOR]

Background: Health practitioner regulators throughout the world use continuing professional development (CPD) standards to ensure that registrants maintain, improve and broaden their knowledge, expertise and competence. As the CPD standard for most regulated health professions in Australia are currently under review, it is timely that an appraisal of the evidence be undertaken. Methods: A systematic review was conducted using major databases (including MEDLINE, EMBASE, PsycInfo, and CINAHL), search engines and grey literature for evidence published between 2015 and April 2022. Publications included in the review were assessed against the relevant CASP checklist for quantitative studies and the McMaster University checklist for qualitative studies. Results: The search yielded 87 abstracts of which 37 full-text articles met the inclusion criteria. The evidence showed that mandatory CPD requirements are a strong motivational factor for their completion and improves practitioners' knowledge and behaviour. CPD that is more interactive is most effective and e-learning is as effective as face-to-face CPD. There is no direct evidence to suggest the optimal quantity of CPD, although there was some evidence that complex or infrequently used skills deteriorate between 4 months to a year after training, depending on the task. Conclusions: CPD is most effective when it is interactive, uses a variety of methods and is delivered in a sequence involving multiple exposures over a period of time that is focused on outcomes considered important by practitioners. Although there is no optimal quantity of CPD, there is evidence that complex skills may require more frequent CPD. [ABSTRACT FROM AUTHOR]

Background: Health practitioner regulators throughout the world use registration standards to define the requirements health practitioners need to meet for registration. These standards commonly include recency of practice (ROP) standards designed to ensure that registrants have sufficient recent practice in the scope in which they intend to work to practise safely. As the ROP registration standards for most National Boards are currently under review, it is timely that an appraisal of current evidence be carried out. Methods: A systematic review was conducted using databases (including MEDLINE, EMBASE, PsycInfo, and CINAHL), search engines, and a review of grey literature published between 2015 and April 2022. Publications included in the review were assessed against the relevant CASP checklist for quantitative studies and the Joanna Briggs Institute checklist for analytical cross-sectional studies. Results: The search yielded 65 abstracts of which 12 full-text articles met the inclusion criteria. Factors that appear to influence skills retention include the length of time away from practice, level of previous professional experience and age, as well as the complexity of the intervention. The review was unable to find a clear consensus on the period of elapsed time after which a competency assessment should be completed. Conclusions: Factors that need to be taken into consideration in developing ROP standards include length of time away from practice, previous experience, age and the complexity of the intervention, however, there is a need for further research in this area. [ABSTRACT FROM AUTHOR]

Objective. This study aims to determine the prevalence of work-related musculoskeletal disorders in prosthetists/orthotists working in Australia. Secondary to this, the relationship between work-related hazards and work-related musculoskeletal disorders will be examined. Methods. In 2012, a self-report survey was conducted with the prosthetist/orthotist workforce in Australia (N = 139, 56% response rate). Data on workplace physical and psychosocial hazards, job satisfaction, work–life balance and musculoskeletal discomfort were collected. Predictors of work-related musculoskeletal disorders were assessed using logistic regression analysis. Results. Prevalence of work-related musculoskeletal disorders was 80%. Gender (β = 1.31, p = 0.030), total weekly hours (β = 0.9, p < 0.010) and physical (β = 1.91, p < 0.010) and psychosocial (β = 1.28, p < 0.010) hazards were all associated with reporting of work-related musculoskeletal disorders. Females reported higher levels of work-related musculoskeletal disorder discomfort than males in all body areas. Conclusions. Work-related musculoskeletal disorders prevalence is high in prosthetists/orthotists. This suggests that focus on workplace injury prevention is required. Targeted prevention requires systematic identification and then control of all relevant workplace hazards. [ABSTRACT FROM AUTHOR]

Background: Previous Australian workforce analyses revealed a small orthotist/prosthetist workforce with a low number of practitioners per 100,000 Australians. In recent years, initiatives were implemented to increase relative workforce size, including a government-led change in immigration policy to facilitate entry of experienced internationally trained orthotist/prosthetists into the Australian workforce. Given these changes, this project aimed to compare demographics of the orthotist/prosthetist workforce in Australia and each state/territory between 2007, 2012 and 2019.Methods: This quasi-experiment analysed data from the Australian Orthotic Prosthetic Association (AOPA) database of certified orthotist/prosthetists, to compare changes in the absolute number of practitioners and the number of practitioners per 100,000 population, as well as practitioner age, gender and service location (i.e., metropolitan, regional/remote) across three time points, with a breakdown by each Australian state and territory.Results: Between 2007 and 2019, the number of orthotist/prosthetists per 100,000 population increased 90%. Average age reduced significantly between 2007 (41.5 years) and 2019 (35 years) (p = 0.001). While the proportion of female practitioners increased significantly between 2007 (30%) and 2019 (49%), and between 2012 (38%) and 2019 (49%) (p < 0.05); only 22% of the female workforce is over 40 years of age. The proportion of practitioners servicing a regional/remote location did not change over time (range 13-14%).Conclusions: Between 2007 and 2019, the national orthotist/prosthetist workforce increased at a rate that exceeded Australia's population growth, became younger, and more female. However, the number of practitioners per 100,000 population remains below international recommendations; particularly in states outside of Victoria and Tasmania, and in regional/remote areas. In addition, low numbers of mid-late career female practitioners suggest challenges to retention of this particular cohort. These data can help inform workforce initiatives to retain a younger and more female workforce, and improve access to orthotic/prosthetic services. [ABSTRACT FROM AUTHOR]

Purpose: To describe the lived experience of people who have undergone sequential partial foot and transtibial amputation. Methods: Using a narrative inquiry approach, adults with experience of sequential partial foot amputation and transtibial amputation on the same limb were sampled until data saturation. Semi-structured, face-to-face interviews were conducted and transcribed verbatim. Each interview was read, coded and a thematic summary with quotes was returned to each participant for verification. Data were triangulated through independent coding and analysis. Results: The lived experiences of the 10 participants were characterized by three themes: enduring complications eventually resolved, health and wellbeing improved with knowledge, and advice from the lived experience. The foot complications that led to partial foot amputation often endured until after transtibial amputation, where participants reported being able to get on with their life. At the point of partial foot amputation, participants had little knowledge about the surgical procedure, likely outcomes or common risks. In the lead up to transtibial amputation, structured systems provided access to peer support and conversations with healthcare professionals. As participants' knowledge improved, many people were able to exercise control over their healthcare decisions. Conclusions: The lived experience highlights the importance of high-quality information and meaningful conversations to inform decision making and prepare people for life with limb loss. Partial foot amputation is associated with high rates of complications and subsequent transtibial amputation At the point of partial foot amputation, most people seem unaware of what the surgery involves or the likelihood of complications and reamputation This research suggests that people facing the prospect of partial foot amputation may benefit from access to the structured systems already in place for most people facing transtibial amputation Access to high-quality information, peer support, and meaningful conversations with healthcare providers can support informed decision making and help people prepare for the likelihood of complications and reamputation following partial foot amputation [ABSTRACT FROM AUTHOR]

Objective: This study aims to identify the number, costs and reported injury mechanisms of serious injury claims for allied health professionals. Methods: Using Australian Workers' Compensation injury data, the number, mechanism, and costs of injury claims were calculated for eight groups of allied health professions (chiropractors and osteopaths, speech pathologists and audiologists, occupational therapists, physiotherapists, psychologists, podiatrists, social workers and prosthetists/orthotists) between the 2000–01 and 2013–14 financial years. Workforce injury rates were calculated using the 2011 Australian Census Workforce data (denominator) and 2011 Workers' Compensation Statistics claims data (numerator). Results: Across the allied health professions, 7023 serious injuries (minimum 5 days absence from work) were recorded with an associated total compensation cost of A$201 970 000. Fewer than 1.5% of each allied health professional group had an injury claim, with the exception of prosthetists/orthotists who had a rate of 25.9% serious injury claims (95% confidence interval 21.9–30.4). The average cost per claim varied across the allied health professions, from the lowest cost of A$19 091 per injury for occupational therapists to the highest of A$48 466 per claim in chiropractic and osteopathy. Body stressing followed by mental stress were the most common mechanisms of injury. Conclusions: Mechanism of injury, both physical and psychosocial, were identified. Prosthetists/orthotists are at the highest risk of workplace injury of all allied health professions. This suggests the need for further investigation and development of appropriately targeted injury prevention programs for each allied health profession. What is known about this topic?: Retention of allied health professionals is a significant issue, with workplace injuries identified as one contributing factor to this problem. Healthcare workers are potentially at high risk of injury as they are exposed to a range of physical and psychosocial hazards in their workplace. What does this paper add?: This paper is the first to report on serious injuries, minimum 5 days absence from work, from Australian Workers' Compensation data, across a range of allied health professions. Various allied health professions were examined to identify the number, mechanism and cost of serious workplace injuries finding there is an average of 500 serious claims per year at a cost of A$14 million. Prosthetists/orthotists were identified as having the highest proportion of claims per workforce population. What are the implications for practitioners?: These results suggest highly varied injury rates across allied health professions. Compensation data does not enable accurate identification of causal factors. Further work is required to identify relevant causal factors so that targeted risk reduction strategies can be developed to reduce workforce injuries. [ABSTRACT FROM AUTHOR]

Recent research conducted in Australia shows that many oncologists withhold information about expensive unfunded drugs in what the authors of the study suggest is unacceptable medical paternalism. Surprised by the Australian results, we ran a version of the study in New Zealand and received very different results. While the percentages of clinicians who would prescribe the drugs described in the scenarios were very similar (73-99% in New Zealand and 72-94% in Australia depending on the scenario) the percentage who would not discuss expensive unfunded drugs was substantially lower in New Zealand (6.4-11.1%) than it was in Australia (28-41%). This seems surprising given the substantial similarities between the two countries, and the extensive interaction between their medical professions. We use the contrast between the two studies to examine the generalisability of the Australian results, to identify influences on clinicians' decisions about what treatment information to give patients, and so the tendency towards medical paternalism and, more pragmatically, about how such decisions might be influenced. [ABSTRACT FROM AUTHOR]

Objective: In 2021, the Australian Health Practitioner Regulation Agency established a support service to provide additional assistance to victim-survivors involved in complaints related to sexual boundary violations. This study evaluates the first stages of service delivery to understand participants' experiences with the service, gauge the service's reception, and improve support provided in future., Design: Programme data was analysed descriptively to understand uptake and participant engagement since inception. Semistructured interviews with a purposive convenience sample of participants who had recently completed service engagement were conducted over 6 months and analysed using reflexive thematic analysis. Findings were triangulated to judge the effectiveness of the support provided by the service and highlight learning and development opportunities., Results: During the study period, 275 participants were referred to the programme and 175 (64%) of those referred had engaged with the service. At the time of analysis, less than a quarter (21%) had refused support or disengaged following referral. Participants reported appreciation of and satisfaction with the support they received from the service and strongly reiterated the need for support in this context. Flexibility and quality communication as part of the service model was associated with participants feeling supported through three main themes: safety and connection, guidance and process navigation and representation and advocacy., Conclusion: Good uptake of the service and positive feedback from participants suggests that the programme has been a valuable and well-received initiative. Exploration of engagement trends as well as a more nuanced analysis of the benefits of support provided would augment these findings., Competing Interests: Competing interests: All authors were current employees of the Australian Health Practitioner Regulation Agency at the time of submission, and declare no further competing interests., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Protection of the public is the paramount aim for health practitioner regulation, yet there has been growing concern globally on the association between regulatory complaints processes and practitioner mental health and wellbeing. The objective was to understand the experience, particularly distress, of health practitioners involved in a regulatory complaints process to identify potential strategies to minimise future risk of distress. Semi-structured qualitative interviews were conducted with health practitioners in Australia who had recently been through a regulatory complaints process, together with a retrospective analysis of documentation relating to all identified cases of self-harm or suicide of health practitioners who were involved in such a process over 4 years. Data from interviews and the serious incident analysis found there were elements of the regulatory complaints process contributing to practitioner distress. These included poor communication, extended time to close the investigation, and the management of health-related concerns. The study found external personal circumstances and pre-existing conditions could put the practitioner at greater risk of distress. There were found to be key moments in the process-triggers-where the practitioner was at particular risk of severe distress. Strong support networks, both personal and professional, were found to be protective against distress. Through process improvements and, where appropriate, additional support for practitioners, we hope to further minimise the risk of practitioner distress and harm when involved in a regulatory complaints process. The findings also point to the need for improved partnerships between regulators and key stakeholders, such as legal defence organisations, indemnity providers, employers, and those with lived experience of complaints processes. Together they can improve the support for practitioners facing a complaint and address the stigma, shame, and fear associated with regulatory complaints processes. This project provides further evidence that a more compassionate approach to regulation has the potential to be better for all parties and, ultimately, the wider healthcare system., (© The Author(s) 2023. Published by Oxford University Press on behalf of International Society for Quality in Health Care.)

Purpose: The aim of this work was to qualitatively explore the personal perspectives of prosthetic and orthotic users, in the context of their past and present experiences and understand their insights for the future., Materials and Methods: A narrative exploration study design, employing a phenomenological approach was used. Semi-structured interviews were conducted with three female and two male prosthetic and orthotic users from Australia and the United Kingdom. Interviews were analysed, coded and key themes and sub-themes identified., Results: Three themes were identified. The Maximising Opportunity theme linked sub-themes of recreation and pushing boundaries. The Health Care Network theme included sub-themes of communication, peer support and building a team. The final theme, Changes over time, included sub-themes of disability perception, advice and advancements over time., Conclusion: Prosthetic and orthotic users identified that there had been vast changes in disability perception, disability rights, and their role in the health care system, along with the variety of technology and materials available. Key findings were that prosthetic and orthotic users want to be listened to, considered central to the health care team, and had a deep understanding of their own health care needs.Implications for rehabilitationProsthesis and orthosis users want to be listened to and considered central within the health care team.Attending medical and allied health teams must recognise that prosthesis and orthosis users have a fundamental understanding of their own health care needs.Themes, whilst potentially generalisable, are derived from specific individuals and may particularly relate to these individuals.

Background: Internationally qualified orthotists/prosthetists who want to practice in Australia must pass a portfolio-based competency assessment. Testing the agreement between independent assessors is important to engender confidence in the assessment, and continually improve the processes., Objectives: To quantify interassessor agreement for all 68 performance indicators in the Australian Orthotic Prosthetic Association's Entry Level Competency Standards and where there was significant disagreement between assessors, to explore the reasons why., Study Design: Mixed methods: explanatory sequential., Method: Fifteen portfolios were assigned to independent assessors. Assessors determined whether the evidence presented met the requirements of each performance indicator. Interassessor agreement was calculated using Gwet's Agreement Coefficient 1 (AC1), and these data informed semistructured interviews to explore the reasons for disagreement., Results: Most performance indicators (87%) had moderate to substantial agreement (AC1 > 0.71), which could be attributed to a variety of factors including the use of a simple assessment rubric with supporting guidelines and assessor training to establish shared expectations. The remaining performance indicators (13%) had fair to slight agreement (AC1 ≤ 0.7). Interviews with assessors suggested that disagreement could be attributed to the complexity of some performance indicators, unconscious bias, and the appropriateness of the evidence presented., Conclusions: Although most performance indicators in Australian Orthotic Prosthetic Association's Entry Level Competency Standard were associated with moderate to substantial interassessor agreement, there are opportunities to improve agreement by simplifying the wording of some performance indicators and revising guidelines to help applicants curate the most appropriate evidence for each performance indicator., (Copyright © 2021 International Society for Prosthetics and Orthotics.)

Aim: The requirement for an allied health workforce is expanding as the global burden of disease increases internationally. To safely meet the demand for an expanded workforce of orthotist/prosthetists in Australia, competency based standards, which are up-to-date and evidence-based, are required. The aims of this study were to determine the minimum level for entry into the orthotic/prosthetic profession; to develop entry level competency standards for the profession; and to validate the developed entry-level competency standards within the profession nationally, using an evidence-based approach., Methods: A mixed-methods research design was applied, using a three-step sequential exploratory design, where step 1 involved collecting and analyzing qualitative data from two focus groups; step 2 involved exploratory instrument development and testing, developing the draft competency standards; and step 3 involved quantitative data collection and analysis - a Delphi survey. In stage 1 (steps 1 and 2), the two focus groups - an expert and a recent graduate group of Australian orthotist/prosthetists - were led by an experienced facilitator, to identify gaps in the current competency standards and then to outline a key purpose, and work roles and tasks for the profession. The resulting domains and activities of the first draft of the competency standards were synthesized using thematic analysis. In stage 2 (step 3), the draft-competency standards were circulated to a purposive sample of the membership of the Australian Orthotic Prosthetic Association, using three rounds of Delphi survey. A project reference group of orthotist/prosthetists reviewed the results of both stages., Results: In stage 1, the expert (n = 10) and the new graduate (n = 8) groups separately identified work roles and tasks, which formed the initial draft of the competency standards. Further drafts were refined and performance criteria added by the project reference group, resulting in the final draft-competency standards. In stage 2, the final draft-competency standards were circulated to 56 members (n = 44 final round) of the Association, who agreed on the key purpose, 6 domains, 18 activities, and 68 performance criteria of the final competency standards., Conclusion: This study outlines a rigorous and evidence-based mixed-methods approach for developing and endorsing professional competency standards, which is representative of the views of the profession of orthotist/prosthetists.