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Abstract Flame
Bridging the Knowledge Gap:
Becoming a Hand Therapist

"We've been educated as generalists.

Our mission is to educate you as specialists." 

-Virtual Hand to Shoulder Fellowship, LLC

Book between mountains gap.  . Overcome any obstacle with education and self development..
Mirella Deisher, OTD, MS, OTR/L, CHT

Written by: Mirella Deisher, OTD, MS, OTR/L, CHT

Virtual Hand to Shoulder Fellowship, LLC

Founder & Faculty

I have always been keenly aware that my occupational therapy (OT) education did not fully prepare me to address physical impairments at the level of a physical therapist. This realization has always troubled me. As a new clinician with a passion for hand therapy, I was disheartened when a colleague pointed out that physical therapists are trained to address impairments, while occupational therapists focus on managing resulting disabilities. While I respected my OT training, I understood the value of a more in-depth understanding of the body's mechanics that physical therapists possess.


Despite my desire for a comprehensive approach to rehabilitation, I chose to pursue a career in occupational therapy because it seemed to offer a balance between addressing physical limitations and considering the individual as a whole. However, working alongside physical therapists highlighted the gaps in my knowledge, particularly in treating upper limb and hand impairments. In response, I enrolled in a physical therapy certificate program specializing in upper quarter and hand therapy in 2000. This additional training significantly enhanced my ability to provide effective care to my patients.


Over the years, I have grappled with the limitations of traditional OT education in preparing clinicians to think critically within a biomechanical framework, especially in the realm of upper extremity rehabilitation. Recognizing this gap, I have dedicated myself to advocating for enhanced education and training opportunities for OTs in this specialized area. Through my experience working with surgeons and leading hand therapy departments, I have gained valuable insights that have shaped my approach to education and practice.


As a faculty member in an occupational therapy doctoral program, I have strived to bridge the knowledge divide by emphasizing the importance of anatomy and biomechanics in clinical practice. While the scope of OT education is broad, I believe that specialized training in areas such as hand therapy is essential for delivering optimal care to patients. This belief has driven me to establish the Virtual Hand to Shoulder Fellowship, a program designed to provide advanced knowledge and skills in upper extremity and hand rehabilitation.


Through the Virtual Hand to Shoulder Fellowship, we offer a scaffolded approach to learning, starting with foundational knowledge and progressing to more complex concepts. Our curriculum includes remote and live experiential learning opportunities, mentorship programs, and resources for clinicians seeking to enhance their skills in hand therapy. We are committed to supporting clinicians in achieving the highest level of competency in this specialized field, regardless of their geographic location or financial constraints.


In conclusion, my journey from OT clinician to educator and advocate for specialized training in hand therapy has been driven by a passion for improving patient outcomes and advancing the field of occupational therapy. I believe that by addressing the knowledge gaps in OT education and providing accessible resources for continued learning, we can empower clinicians to deliver exceptional care to individuals with upper limb and hand impairments.

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