Mary Goldberg | University of Pittsburgh (original) (raw)

Papers by Mary Goldberg

Disability and Rehabilitation: Assistive Technology

Purpose: Appropriate wheelchair provision is necessary for addressing participation barriers expe... more Purpose: Appropriate wheelchair provision is necessary for addressing participation barriers experienced by individuals with mobility impairments. Health care professionals involved in the wheelchair service provision process require a specific set of skills and knowledge to enable wheelchair use that meets individual posture, mobility and daily living requirements. However, inconsistencies exist in academic programmes globally about providing comprehensive education and training programmes. The planned scoping review aims to review and synthesize the global literature on wheelchair service provision education for healthcare professional students, healthcare personnel and educators offered by universities, organizations and industries. Methods: This scoping review will be guided by the Joanna Briggs Institute (JBI) methodological framework. Comprehensive literature searches will be conducted on various global electronic databases on health to seek out how wheelchair service provision education is organized, integrated, implemented and evaluated. Two independent reviewers will perform eligibility decisions and key data extractions. Data from selected studies will be extracted and analysed using conventional content analysis. Information related to wheelchair service provision education including curriculum development, content, teaching methods, evaluation and models of integration will be synthesized. Implications and dissemination: The planned scoping review will be the first to examine all aspects of wheelchair service provision education across professionals, settings and countries. We anticipate that results will inform the content of a Wheelchair Educators' Package, and if appropriate, a follow-up systematic review. An article reporting the results of the scoping review will be submitted for publication to a scientific journal. ä IMPLICATIONS FOR REHABILITATION A comprehensive examination of wheelchair service provision education could help develop strategies to address the unmet need for wheelchair services globally. Findings for this review will facilitate the planning and development of an evidence-based education package that could bridge the existing knowledge gaps related to safe and effective wheelchair service provision among health professionals involved. This review will also inform the potential barriers and enablers for effective integration and implementation of wheelchair service provision education worldwide.

Disability and Rehabilitation: Assistive Technology

2014 ASEE Annual Conference & Exposition Proceedings

2013 ASEE Annual Conference & Exposition Proceedings

2011 ASEE Annual Conference & Exposition Proceedings

PLOS ONE

Background Evidence highlights a global shortage of wheelchair service provision education and tr... more Background Evidence highlights a global shortage of wheelchair service provision education and training that results in inappropriate wheelchair provision with associated health and economic consequences. Two learning methodologies, a hybrid and an in-person course, based on the World Health Organization Wheelchair Service Training Package Basic Level, currently are available to train wheelchair service providers worldwide. The effectiveness of the in-person methodology, used as the standard of practice, has never been tested. Meanwhile, the Hybrid Course, which combines online and in-person training, was developed to reduce training costs and to scale training interventions and has shown potential effectiveness in increasing basic level wheelchair service provision knowledge. The objective of this study was to compare the effectiveness of both learning methodologies based on knowledge and satisfaction among a group of wheelchair service providers in India and Mexico. Methods We conducted a controlled quasi-experimental study to evaluate changes in basic wheelchair knowledge and levels of satisfaction between Hybrid and In-person course learners in India and Mexico. A convenience sampling method guided by local stakeholders' input was used to recruit participants. Outcomes were assessed using self-administered online surveys, the International Society of Wheelchair Professionals Wheelchair Service Provision Basic Test (primary outcome) completed pre-and post-the learning intervention and an anonymous Satisfaction Survey (secondary outcome) completed post-intervention. Baseline characteristics were compared among groups using hypothesis tests based on their assumptions. The primary analysis was intention-to-treat. To address missing values and

PLOS ONE

Introduction People with mobility impairments often rely on wheelchairs as their primary means of... more Introduction People with mobility impairments often rely on wheelchairs as their primary means of mobility. Untrained wheelchair service providers may provide inappropriate wheelchairs and services which result in negative consequences in wheelchair users' health, quality of life, safety, and social participation. This study aimed to evaluate the influence of the Spanish Hybrid Course on Basic Wheelchair Service Provision, a training based on the World Health Organization's Wheelchair Service Training Program-Basic Level, to increase knowledge in basic level wheelchair service provision among a group of wheelchair service providers from Colombia. In addition, we developed a satisfaction survey which participants completed after the training to understand levels of satisfaction with the training intervention. Methods A quasi-experimental study was conducted to evaluate changes in basic level wheelchair knowledge using the Wheelchair Service Provision-Basic Test. Paired sample t tests were used to assess pre-and post-training changes in basic level wheelchair knowledge. The Hybrid Satisfaction Survey was developed in collaboration with a multidisciplinary, international stakeholders' group. The survey's construct of interest was level of satisfaction determined by interaction, instructor, instruction methodology, content, and technology, using a five-point Likert scale (0 = strongly disagree to 4 = strongly agree). The survey was completed anonymously after the training intervention and analyzed using frequencies and percentages. Results Fifteen wheelchair service providers in Colombia completed the Spanish Hybrid Course. Mean post-scores were significantly higher (Mean (M) = 56.13, Standard Deviation (SD) = 7.8), than pre-assessment scores (M = 50.07, SD = 8.38, t(14) = 4.923, p = <0.0001).

Occupational Therapy International

Access to personal mobility is a human right and as such, it implies the provision of wheelchair ... more Access to personal mobility is a human right and as such, it implies the provision of wheelchair services for those with mobility impairments that need one. Lack of appropriately trained personnel is a major contributor to the gap in access to wheelchairs. Assistive technology provision is one of the core competencies of occupational therapists. The goal of this study was to assess the current wheelchair provision knowledge of final year occupational therapy students in Colombia as measured by the International Society of Wheelchair Professionals Basic Wheelchair Service Knowledge Test. A total of 83 students from 7 universities took the test. None of the students met the 70% passing threshold. The highest scores were in the assessment domain while the lowest in the fitting and user training domains. These results suggest that the current wheelchair provision education received in these programs do not meet the World Health Organization guidelines on appropriate wheelchair provision...

Human Resources for Health

Background: Insufficient wheelchair training among rehabilitation professionals has been identifi... more Background: Insufficient wheelchair training among rehabilitation professionals has been identified as an important factor that hinders access to appropriate wheelchair services. The aim of this study was to develop a toolkit to promote the integration of wheelchair education into academic curricula of rehabilitation programs. Methods: A participatory action research design was carried out in three phases: (1) development of the Initial and Alpha Versions involving secondary analyses of surveys (n = 72), interviews (n = 14), and academic training partners meeting presentations (n = 16); (2) development of the Beta Version based on feedback from collaborators (n = 21); and (3) development of the Launch Version based on feedback from participants attending presentations of the Beta Version at conferences, symposiums, and webinars (n = 94). Results: Over 100 individuals participated in reviews of the Seating and Mobility Academic Resource Toolkit (SMART). Initial development addressed modifiable factors that perpetuate insufficient wheelchair education in academic curricula (e.g., limited awareness, limited expertise). Internal feedback on the web-based Alpha Version resulted in modifications of appearance and multimedia, structure and design, and navigation. External feedback then led primarily to fine-tuning the navigation of SMART. Positive reviews were received from global wheelchair professionals (i.e., educators, researchers, clinicians). The Launch Version of the SMART (smart.wheelchairnetwork.org) provides a forum for sharing and accessing resources to inform the integration and enhancement of wheelchair content into university rehabilitation programs. Conclusions: As an open-source open-access online "living document," SMART has the potential to promote the integration of wheelchair service provision education into academic curricula of rehabilitation programs. Future studies will explore the ease of use and the effectiveness of the SMART.

Physical Medicine and Rehabilitation Clinics of North America

Disability and Rehabilitation: Assistive Technology

International Journal for Service Learning in Engineering, Humanitarian Engineering and Social Entrepreneurship

This paper describes the design-based service learning model utilized to provide an engaging STEM... more This paper describes the design-based service learning model utilized to provide an engaging STEM experience to local K-12 science and math teachers and U.S. military veterans returning from service and transitioning to secondary education. A critical factor that can contribute to increased student outcomes from a service-learning program is the level of preparation a teacher has as a mediator of knowledge and an active partner. Professional development activities directed towards in-service teachers could potentially alleviate this issue. Furthermore, such activities, when combined with well-developed inquiry-based learning pedagogy, could provide for increased engagement and understanding of STEM of students. Recent evidence shows that veterans may be more likely than the general population to be interested and well suited for a career in engineering. With more than two million veterans returning from service in the near future, the shortage in undergraduate engineering enrollment...

Journal of Applied Rehabilitation Counseling

People with disabilities (PwD) are two times as likely to be unemployed as the general population... more People with disabilities (PwD) are two times as likely to be unemployed as the general population and are particularly not well represented in advanced manufacturing (AM) fields. This study, which features the Advancing Inclusive Manufacturing (AIM) program located at a large University in the Northeast, serves as one approach to empowering PwD by teaching them the skills needed to be successful in an advanced manufacturing (AM) career. The program components help participants identify strengths and build self-advocacy to progress to a subsequent career stage. Seventy-five percent of AIM graduates entered the workforce or continued their education while 25% are pursuing employment in the AM sector. These results suggest the AIM program may result in PwD' re-integration to the workforce and interest in continued professional development. Despite the AM focus of the AIM program, the results are still unclear whether the program is successful in sustained employment in that particu...

Disability and Rehabilitation: Assistive Technology

Purpose: Access to an appropriate wheelchair is a human right. Only between 5-15% of people who n... more Purpose: Access to an appropriate wheelchair is a human right. Only between 5-15% of people who need a wheelchair have access to one. One of the key barriers to access is the lack of appropriately trained rehabilitation professionals. The objective of this study was to evaluate basic manual wheelchair provision knowledge in final-year physiotherapy undergraduate students in two programs in Colombia. Materials and methods: Students took the International Society of Wheelchair Professionals Wheelchair Service Provision-Basic Test which was administered online and in Spanish. The minimum score to pass the test is 70%; it assesses seven domains: Assessment; Prescription; Products; Fitting; User training; Follow-up, maintenance, and repairs; and Process. Results and conclusions: One-hundred sixteen students took the test and no one passed the test. The highest median domain scores were in Assessment and Process while the lowest were in Fitting and Products. The limitations of this study include that this sample does not represent all physiotherapy programmes or students in Colombia, there may be potential errors in the Spanish translation of the outcome measure, and students encountered Internet connectivity issues during the test that may have impacted their scores. Immediate interventions are required to improve teaching and students' learning outcomes related to basic manual wheelchair provision in these two programs. This study may serve as a foundation for future regional or national studies that assess the situation of wheelchair provision training in rehabilitation programs that will inform improvement actions. This manuscript is also available in Spanish as Supplemental Material. ä IMPLICATIONS FOR REHABILITATION This study indicates that students' current knowledge on basic appropriate manual wheelchair provision from two physiotherapy programs in Colombia is insufficient. Students' knowledge does not align with the minimum guidelines recommended for wheelchair service provision by the World Health Organization. Objectively identifying the gap in knowledge in rehabilitation trainees (i.e., physiotherapy students) is a strategy to promote the inclusion of assistive technology related content in formal academic training. The need to include formal training of appropriate wheelchair provision persists and without this training, people with disabilities who require a wheelchair for mobility will continue to face barriers to full participation in society.

Disability and Rehabilitation: Assistive Technology

Disability and Rehabilitation: Assistive Technology

PLOS ONE

Introduction Wheelchair users worldwide are at high risk of developing secondary health condition... more Introduction Wheelchair users worldwide are at high risk of developing secondary health conditions and premature death due to inappropriate wheelchair provision by untrained providers. The International Society of Wheelchair Professionals (ISWP) has developed a Hybrid Course based on the World Health Organization's Wheelchair Service Training Package-Basic Level. The Hybrid Course leverages online modules designed for low-bandwidth internet access that reduces the in-person training exposure from five to three and a half days, making it less expensive and more convenient for both trainees and trainers.

British Journal of Occupational Therapy

Rehabilitation conferences often have an opening theme of 'look how far we have come', but the cl... more Rehabilitation conferences often have an opening theme of 'look how far we have come', but the closing message is 'look how far we have to go'. This was true for the 2018 European Seating Symposium (EES), in Dublin, Ireland focusing on mobility and postural support devices. 'Before and after' pictures of products over the last 30 years suggest that technology has become more available in more contexts, including a recent wave of DIY technology with the ubiquity of 3D printing and scanning tools to produce custom equipment. The impressive evolution of this technology is not the whole story; in practice, many people do not have access, and policy and training efforts related to both service and rehabilitation equipment are often inadequate to ensure users receive appropriate products (MacLachlan et al., 2018). This disparity will increase as those who require assistive technology (AT) will double by 2050, to 2 billion users. Meanwhile, 90% of users do not have access, and live in less-resourced settings (World Health Organization (WHO), 2018). Addressing this disparity is the aim of the United Nations (UN) Convention on the Rights of Persons with Disabilities, signed by 187 countries worldwide, and Sustainable Development Goals, that ensure healthy lives and promote wellbeing for all, at all ages (UN, 2006). In May 2018, a World Health Assembly resolution was adopted by the UN member states to develop, implement and strengthen policies and programs to improve access to AT. The need for wheelchairs is just as great. The WHO suggests that 68 million people need wheelchairs in lessresourced settings. The problem is multi-faceted, but a core barrier is lack of access to appropriate training, including for occupational therapists, and limited capacity to provide wheelchairs worldwide. An appropriate wheelchair can prevent secondary health complications, enhance quality of life, and facilitate access to human rights such as education, healthcare, and employment (WHO, 2008).

Disability and Rehabilitation: Assistive Technology

Purpose: Appropriate wheelchair provision is necessary for addressing participation barriers expe... more Purpose: Appropriate wheelchair provision is necessary for addressing participation barriers experienced by individuals with mobility impairments. Health care professionals involved in the wheelchair service provision process require a specific set of skills and knowledge to enable wheelchair use that meets individual posture, mobility and daily living requirements. However, inconsistencies exist in academic programmes globally about providing comprehensive education and training programmes. The planned scoping review aims to review and synthesize the global literature on wheelchair service provision education for healthcare professional students, healthcare personnel and educators offered by universities, organizations and industries. Methods: This scoping review will be guided by the Joanna Briggs Institute (JBI) methodological framework. Comprehensive literature searches will be conducted on various global electronic databases on health to seek out how wheelchair service provision education is organized, integrated, implemented and evaluated. Two independent reviewers will perform eligibility decisions and key data extractions. Data from selected studies will be extracted and analysed using conventional content analysis. Information related to wheelchair service provision education including curriculum development, content, teaching methods, evaluation and models of integration will be synthesized. Implications and dissemination: The planned scoping review will be the first to examine all aspects of wheelchair service provision education across professionals, settings and countries. We anticipate that results will inform the content of a Wheelchair Educators' Package, and if appropriate, a follow-up systematic review. An article reporting the results of the scoping review will be submitted for publication to a scientific journal. ä IMPLICATIONS FOR REHABILITATION A comprehensive examination of wheelchair service provision education could help develop strategies to address the unmet need for wheelchair services globally. Findings for this review will facilitate the planning and development of an evidence-based education package that could bridge the existing knowledge gaps related to safe and effective wheelchair service provision among health professionals involved. This review will also inform the potential barriers and enablers for effective integration and implementation of wheelchair service provision education worldwide.

Disability and Rehabilitation: Assistive Technology

2014 ASEE Annual Conference & Exposition Proceedings

2013 ASEE Annual Conference & Exposition Proceedings

2011 ASEE Annual Conference & Exposition Proceedings

PLOS ONE

Background Evidence highlights a global shortage of wheelchair service provision education and tr... more Background Evidence highlights a global shortage of wheelchair service provision education and training that results in inappropriate wheelchair provision with associated health and economic consequences. Two learning methodologies, a hybrid and an in-person course, based on the World Health Organization Wheelchair Service Training Package Basic Level, currently are available to train wheelchair service providers worldwide. The effectiveness of the in-person methodology, used as the standard of practice, has never been tested. Meanwhile, the Hybrid Course, which combines online and in-person training, was developed to reduce training costs and to scale training interventions and has shown potential effectiveness in increasing basic level wheelchair service provision knowledge. The objective of this study was to compare the effectiveness of both learning methodologies based on knowledge and satisfaction among a group of wheelchair service providers in India and Mexico. Methods We conducted a controlled quasi-experimental study to evaluate changes in basic wheelchair knowledge and levels of satisfaction between Hybrid and In-person course learners in India and Mexico. A convenience sampling method guided by local stakeholders' input was used to recruit participants. Outcomes were assessed using self-administered online surveys, the International Society of Wheelchair Professionals Wheelchair Service Provision Basic Test (primary outcome) completed pre-and post-the learning intervention and an anonymous Satisfaction Survey (secondary outcome) completed post-intervention. Baseline characteristics were compared among groups using hypothesis tests based on their assumptions. The primary analysis was intention-to-treat. To address missing values and

PLOS ONE

Introduction People with mobility impairments often rely on wheelchairs as their primary means of... more Introduction People with mobility impairments often rely on wheelchairs as their primary means of mobility. Untrained wheelchair service providers may provide inappropriate wheelchairs and services which result in negative consequences in wheelchair users' health, quality of life, safety, and social participation. This study aimed to evaluate the influence of the Spanish Hybrid Course on Basic Wheelchair Service Provision, a training based on the World Health Organization's Wheelchair Service Training Program-Basic Level, to increase knowledge in basic level wheelchair service provision among a group of wheelchair service providers from Colombia. In addition, we developed a satisfaction survey which participants completed after the training to understand levels of satisfaction with the training intervention. Methods A quasi-experimental study was conducted to evaluate changes in basic level wheelchair knowledge using the Wheelchair Service Provision-Basic Test. Paired sample t tests were used to assess pre-and post-training changes in basic level wheelchair knowledge. The Hybrid Satisfaction Survey was developed in collaboration with a multidisciplinary, international stakeholders' group. The survey's construct of interest was level of satisfaction determined by interaction, instructor, instruction methodology, content, and technology, using a five-point Likert scale (0 = strongly disagree to 4 = strongly agree). The survey was completed anonymously after the training intervention and analyzed using frequencies and percentages. Results Fifteen wheelchair service providers in Colombia completed the Spanish Hybrid Course. Mean post-scores were significantly higher (Mean (M) = 56.13, Standard Deviation (SD) = 7.8), than pre-assessment scores (M = 50.07, SD = 8.38, t(14) = 4.923, p = <0.0001).

Occupational Therapy International

Access to personal mobility is a human right and as such, it implies the provision of wheelchair ... more Access to personal mobility is a human right and as such, it implies the provision of wheelchair services for those with mobility impairments that need one. Lack of appropriately trained personnel is a major contributor to the gap in access to wheelchairs. Assistive technology provision is one of the core competencies of occupational therapists. The goal of this study was to assess the current wheelchair provision knowledge of final year occupational therapy students in Colombia as measured by the International Society of Wheelchair Professionals Basic Wheelchair Service Knowledge Test. A total of 83 students from 7 universities took the test. None of the students met the 70% passing threshold. The highest scores were in the assessment domain while the lowest in the fitting and user training domains. These results suggest that the current wheelchair provision education received in these programs do not meet the World Health Organization guidelines on appropriate wheelchair provision...

Human Resources for Health

Background: Insufficient wheelchair training among rehabilitation professionals has been identifi... more Background: Insufficient wheelchair training among rehabilitation professionals has been identified as an important factor that hinders access to appropriate wheelchair services. The aim of this study was to develop a toolkit to promote the integration of wheelchair education into academic curricula of rehabilitation programs. Methods: A participatory action research design was carried out in three phases: (1) development of the Initial and Alpha Versions involving secondary analyses of surveys (n = 72), interviews (n = 14), and academic training partners meeting presentations (n = 16); (2) development of the Beta Version based on feedback from collaborators (n = 21); and (3) development of the Launch Version based on feedback from participants attending presentations of the Beta Version at conferences, symposiums, and webinars (n = 94). Results: Over 100 individuals participated in reviews of the Seating and Mobility Academic Resource Toolkit (SMART). Initial development addressed modifiable factors that perpetuate insufficient wheelchair education in academic curricula (e.g., limited awareness, limited expertise). Internal feedback on the web-based Alpha Version resulted in modifications of appearance and multimedia, structure and design, and navigation. External feedback then led primarily to fine-tuning the navigation of SMART. Positive reviews were received from global wheelchair professionals (i.e., educators, researchers, clinicians). The Launch Version of the SMART (smart.wheelchairnetwork.org) provides a forum for sharing and accessing resources to inform the integration and enhancement of wheelchair content into university rehabilitation programs. Conclusions: As an open-source open-access online "living document," SMART has the potential to promote the integration of wheelchair service provision education into academic curricula of rehabilitation programs. Future studies will explore the ease of use and the effectiveness of the SMART.

Physical Medicine and Rehabilitation Clinics of North America

Disability and Rehabilitation: Assistive Technology

International Journal for Service Learning in Engineering, Humanitarian Engineering and Social Entrepreneurship

This paper describes the design-based service learning model utilized to provide an engaging STEM... more This paper describes the design-based service learning model utilized to provide an engaging STEM experience to local K-12 science and math teachers and U.S. military veterans returning from service and transitioning to secondary education. A critical factor that can contribute to increased student outcomes from a service-learning program is the level of preparation a teacher has as a mediator of knowledge and an active partner. Professional development activities directed towards in-service teachers could potentially alleviate this issue. Furthermore, such activities, when combined with well-developed inquiry-based learning pedagogy, could provide for increased engagement and understanding of STEM of students. Recent evidence shows that veterans may be more likely than the general population to be interested and well suited for a career in engineering. With more than two million veterans returning from service in the near future, the shortage in undergraduate engineering enrollment...

Journal of Applied Rehabilitation Counseling

People with disabilities (PwD) are two times as likely to be unemployed as the general population... more People with disabilities (PwD) are two times as likely to be unemployed as the general population and are particularly not well represented in advanced manufacturing (AM) fields. This study, which features the Advancing Inclusive Manufacturing (AIM) program located at a large University in the Northeast, serves as one approach to empowering PwD by teaching them the skills needed to be successful in an advanced manufacturing (AM) career. The program components help participants identify strengths and build self-advocacy to progress to a subsequent career stage. Seventy-five percent of AIM graduates entered the workforce or continued their education while 25% are pursuing employment in the AM sector. These results suggest the AIM program may result in PwD' re-integration to the workforce and interest in continued professional development. Despite the AM focus of the AIM program, the results are still unclear whether the program is successful in sustained employment in that particu...

Disability and Rehabilitation: Assistive Technology

Purpose: Access to an appropriate wheelchair is a human right. Only between 5-15% of people who n... more Purpose: Access to an appropriate wheelchair is a human right. Only between 5-15% of people who need a wheelchair have access to one. One of the key barriers to access is the lack of appropriately trained rehabilitation professionals. The objective of this study was to evaluate basic manual wheelchair provision knowledge in final-year physiotherapy undergraduate students in two programs in Colombia. Materials and methods: Students took the International Society of Wheelchair Professionals Wheelchair Service Provision-Basic Test which was administered online and in Spanish. The minimum score to pass the test is 70%; it assesses seven domains: Assessment; Prescription; Products; Fitting; User training; Follow-up, maintenance, and repairs; and Process. Results and conclusions: One-hundred sixteen students took the test and no one passed the test. The highest median domain scores were in Assessment and Process while the lowest were in Fitting and Products. The limitations of this study include that this sample does not represent all physiotherapy programmes or students in Colombia, there may be potential errors in the Spanish translation of the outcome measure, and students encountered Internet connectivity issues during the test that may have impacted their scores. Immediate interventions are required to improve teaching and students' learning outcomes related to basic manual wheelchair provision in these two programs. This study may serve as a foundation for future regional or national studies that assess the situation of wheelchair provision training in rehabilitation programs that will inform improvement actions. This manuscript is also available in Spanish as Supplemental Material. ä IMPLICATIONS FOR REHABILITATION This study indicates that students' current knowledge on basic appropriate manual wheelchair provision from two physiotherapy programs in Colombia is insufficient. Students' knowledge does not align with the minimum guidelines recommended for wheelchair service provision by the World Health Organization. Objectively identifying the gap in knowledge in rehabilitation trainees (i.e., physiotherapy students) is a strategy to promote the inclusion of assistive technology related content in formal academic training. The need to include formal training of appropriate wheelchair provision persists and without this training, people with disabilities who require a wheelchair for mobility will continue to face barriers to full participation in society.

Disability and Rehabilitation: Assistive Technology

Disability and Rehabilitation: Assistive Technology

PLOS ONE

Introduction Wheelchair users worldwide are at high risk of developing secondary health condition... more Introduction Wheelchair users worldwide are at high risk of developing secondary health conditions and premature death due to inappropriate wheelchair provision by untrained providers. The International Society of Wheelchair Professionals (ISWP) has developed a Hybrid Course based on the World Health Organization's Wheelchair Service Training Package-Basic Level. The Hybrid Course leverages online modules designed for low-bandwidth internet access that reduces the in-person training exposure from five to three and a half days, making it less expensive and more convenient for both trainees and trainers.

British Journal of Occupational Therapy

Rehabilitation conferences often have an opening theme of 'look how far we have come', but the cl... more Rehabilitation conferences often have an opening theme of 'look how far we have come', but the closing message is 'look how far we have to go'. This was true for the 2018 European Seating Symposium (EES), in Dublin, Ireland focusing on mobility and postural support devices. 'Before and after' pictures of products over the last 30 years suggest that technology has become more available in more contexts, including a recent wave of DIY technology with the ubiquity of 3D printing and scanning tools to produce custom equipment. The impressive evolution of this technology is not the whole story; in practice, many people do not have access, and policy and training efforts related to both service and rehabilitation equipment are often inadequate to ensure users receive appropriate products (MacLachlan et al., 2018). This disparity will increase as those who require assistive technology (AT) will double by 2050, to 2 billion users. Meanwhile, 90% of users do not have access, and live in less-resourced settings (World Health Organization (WHO), 2018). Addressing this disparity is the aim of the United Nations (UN) Convention on the Rights of Persons with Disabilities, signed by 187 countries worldwide, and Sustainable Development Goals, that ensure healthy lives and promote wellbeing for all, at all ages (UN, 2006). In May 2018, a World Health Assembly resolution was adopted by the UN member states to develop, implement and strengthen policies and programs to improve access to AT. The need for wheelchairs is just as great. The WHO suggests that 68 million people need wheelchairs in lessresourced settings. The problem is multi-faceted, but a core barrier is lack of access to appropriate training, including for occupational therapists, and limited capacity to provide wheelchairs worldwide. An appropriate wheelchair can prevent secondary health complications, enhance quality of life, and facilitate access to human rights such as education, healthcare, and employment (WHO, 2008).