Step Description: Fitting entails trial of the wheelchair and cushion by the user and final adjustments to ensure the wheelchair is correctly assembled and set up to meet the user’s needs. 

Planning considerations: For live demonstrations, think about where fitting will be carried out and how it is set up. If user volunteers are available, consider small working groups, in order to have an appropriate learner to user ratio, and not overwhelm the user with too many people. Student: instructor and students: wheelchair user ratios.  It will be useful to have enough support staff around to assist with monitoring the groups.

Human resources: Trained educator, you may contact a local wheelchair vendor that conducts appropriate fittings.

Location/facility: A classroom with enough space to have the wheelchairs.

How to teach the content:

• You may need to make arrangements for wheelchair users and a matching range of assembled wheelchairs and cushions. It may be useful to collaborate with your local wheelchair service or rehab centre in order to identify appropriate users and source appropriate products. 
• Case studies with examples of common fitting problems will also give pupils an opportunity to discuss simple solutions to address those problems.
•  If you have no access to wheelchair users or products, it will be useful to have a selection of videos which demonstrate each stage of the fitting process. 

Recommended equipment and tools:

• Assembled wheelchairs and cushions.

• If pressure mats are available in your context, consider having this equipment available.

• If practical sessions involve actual users and wheelchairs, ensure there is an adequate number of tool kits for each small group, and ensure that the tools are compatible with the type of wheelchairs available.

Documentation:

• You may also find it useful to liaise with your local wheelchair service and use their documentation.
• WHO fitting checklist.
• Product specification sheet and assembly / adjustment manuals.

Other comments related to contextual adaptation/implementation: 

• Cultural sensitivity is important during practical demonstrations of the fitting process, especially when checking for size, and performing the finger pressure test, where pressure mapping equipment is not available.
• If you are not going to teach Step 2 (Assessment), consider including as part of Step 6 (fitting) the learning objectives regarding the examination of pressure injuries, personal and physical factors and body measurement so your students learn about personal and contextual factors that influence a prescription and also how to take body measurements and understand basic of pressure injuries risk factors. This knowledge is needed to be able to fit a wheelchair and cushion to meet the user’s requirements.  
• If you are not going to teach Step 3 (Prescription), consider including as part of Step 6 (fitting) the learning objectives regarding the description of manual wheelchairs and cushions so your students learn about the different wheelchair and cushions features and adjustability. This knowledge is needed to be able to fit a wheelchair and cushion to meet the user’s requirements.   

Learning Objective

List the steps involved in wheelchair and cushion fitting.

How to Teach

Lecture (online or in-person) fitting steps. 

Live class of fitting demonstration .

Practice session of fitting.

Wheelchair & cushion fitting manuals.

How to Evaluate

Observe the practice. 

Percentage of fitting checklist covered. 

Demonstrate fitting procedures.

Quiz.

Learning Objective

Understand common fitting problems and associated solutions in wheelchair adjustment, including returning the product.

How to Teach

Theoretical learning. 

Live demonstration on a wheelchair user. 

Practical understanding/learning. 

User feedback learning. 

Fitting process.

Practical learning.

How to Evaluate

Case study evaluation.

Evaluate fitted product & user.

Demonstration of fitting problem solving.

Quizzes.

Evaluate understanding of the problem through case studies.

Learning Objective

Demonstrates the technique to evaluate the appropriateness of the pressure distribution achieved with the cushion being fitted(e.g. manual pressure test; pressure map).

How to Teach

Theory & practical learning sessions. 

Recorded (videos) learning.

How to Evaluate

Quizzes.

Practical demonstration/evaluation.

Learning Objective

Execute the fitting process in a culturally appropriate manner promoting cooperation and confidence.

How to Teach

Practical sessions  with users or role play.

Recorded learning the local culture & customs. 

• You can use this form from an Occupational Therapy program at University of Jordan, Jordan.

How to Evaluate

Evaluate cultural competence through quizzes – written & oral.

Group work/activity.