Occupational therapy entry-level education in Australia: which path(s) to take?

The impact of Nursing and Midwifery Council revalidation on the professional identity of academic staff in a higher education institution: A qualitative study

AIMS

To explore Nursing and Midwifery Council (NMC) revalidation as a process experienced by nursing and midwifery academics and its impact on their sense of professional identity.

BACKGROUND

The introduction of revalidation nurses and midwives in the UK in 2016 caused some anxiety amongst registrants in higher education.

DESIGN

A qualitative study using a purposeful sample involving thematic analysis of semi-structured interviews with academic staff.

METHODS

Ten registrants completed a semi-structured interview in a higher education institution.

RESULTS/FINDINGS

Clinical credibility: participants were self-conscious about time away from practice but retained strong links with clinical settings reviewing evidence and reports of current practice. The revalidation process: staff were generally positive about NMC revalidation. Professional identity: participants identified as nurses and midwives first and academics second.

CONCLUSIONS

The findings replicate previous studies about professional identity among healthcare professionals in higher education; this study reports the contribution of revalidation amongst nurses and midwives in higher education institutions.

The entry-level occupational therapy clinical doctorate: The next education wave of change in Canada?

BACKGROUND

Currently, Canada and the United States are the only two countries that mandate entry to the occupational therapy profession at the master's level. There was a recommendation considered by the American Occupational Therapy Association that by 2025 all education programs would move to the clinical doctorate level. In August 2015, the Accreditation Council for Occupational Therapy Education made the formal decision that for now, the entry-level qualification for occupational therapists in the United States will remain at both the master's and clinical doctorate levels.

PURPOSE

This article presents an overview of the types of doctorates available, the pros and cons of moving to the clinical doctorate, and some potential questions that will need to be considered.

KEY ISSUES

Is the next step in the educational progression of occupational therapy in Canada the entry-level clinical doctorate? What are the potential implications for the profession, our clients, and funders?

IMPLICATIONS

Further discourse and investigation of this issue is needed.

Six principles to enhance health workforce flexibility

This paper proposes approaches to break down the boundaries that reduce the ability of the health workforce to respond to population needs, or workforce flexibility. Accessible health services require sufficient numbers and types of skilled workers to meet population needs. However, there are several reasons that the health workforce cannot or does not meet population needs. These primarily stem from workforce shortages. However, the health workforce can also be prevented from responding appropriately and efficiently because of restrictions imposed by professional boundaries, funding models or therapeutic partitions. These boundaries limit the ability of practitioners to effectively diagnose and treat patients by restricting access to specific skills, technologies and services. In some cases, these boundaries not only reduce workforce flexibility, but they introduce inefficiencies in the form of additional clinical transactions and costs, further detracting from workforce responsiveness. Several new models of care are being developed to enhance workforce flexibility by enabling existing staff to work to their full scope of practice, extend their roles or by introducing new workers. Expanding on these concepts, this theoretical paper proposes six principles that have the potential to enhance health workforce flexibility, specifically: 1. Measure health system performance from the perspective of the patient. 2. Minimise training times. 3. Regulate tasks (competencies), not professions. 4. Match rewards and indemnity to the levels of skill and risk required to perform a particular task, not professional title. 5. Ensure that practitioners have all the skills they need to perform the tasks required to work in the environment in which they work 6. Enable practitioners to work to their full scope of practice delegate tasks where required These proposed principles will challenge some of the existing social norms around health-care delivery; however, many of these principles are already being applied, albeit on a small scale. This paper discusses the implications of these reforms.

PROPOSED DISCUSSION POINTS

1. Is person-centred care at odds with professional monopolies? 2. Should the state regulate professions and, by doing so, protect professional monopolies or, instead, regulate tasks or competencies? 3. Can health-care efficiency be enhanced by reducing the number of clinical transactions required to meet patient needs?

The entry-level occupational therapy clinical doctorate: advantages, challenges, and international issues to consider

Internationally, occupational therapy education has gone through several paradigm shifts during the last few decades, moving from certificate to diploma to bachelors to masters and now in some instances to clinical doctorate as the entry-level professional credential to practice. In the United States there is a recommendation under consideration by the American Occupational Therapy Association (AOTA) that by 2025, all occupational therapy university programs will move to the clinical doctorate level. It should be noted, however, that the AOTA Board can only make recommendations and it is the Accreditation Council for Occupational Therapy Education (ACOTE) who has regulatory authority to approve such a change. What are the potential implications for the profession, our clients, and funders of occupational therapy services? What are the primary drivers for the move towards the clinical doctorate being the educational entry point? Is the next step in the evolution of occupational therapy education globally a shift to the entry-level clinical doctorate? This article reviews current literature and discusses issues about the occupational therapy entry-level clinical doctorate. The published evidence available about the occupational therapy entry-level clinical doctorate is summarized and the perceived or frequently cited pros and cons of moving to the clinical doctorate as the singular entry point to occupational therapy practice are considered. The potential impacts of the introduction of the clinical doctorate as the entry-to-practice qualification across the United States on the occupational therapy community internationally will be briefly discussed. If the United States moves toward the entry-level clinical doctorate as the only educational starting point for the profession, will other jurisdictions follow suit? Further discourse and investigation of this issue both inside and outside of the United States is needed so that informed decisions can be made.

Master's Level Occupational Therapy Students on Placement: An Exploration of Perceptions and Expectations

Introduction:

The aims of this exploratory mixed methods study were to explore practice placement educators' perceptions and expectations of pre-registration master's level students on placement and to compare the findings of educators who had previous experience of master's level students with those who had none.

Method:

Twenty-six educators completed questionnaires and four took part in semi-structured interviews; forty placement reports were reviewed.

Findings:

The findings show that many educators have higher expectations of master's level students than they do of undergraduate students, due to perceptions of maturity and previous education, life, and work experience. These expectations were contradicted, however, by concerns that master's level students achieve less academic and clinical competence in the shorter time frame for study. Staff with no prior experience at this level lacked confidence in their own abilities to meet the challenge of supporting a master's level student, while staff experienced at this level found many benefits for their own learning as well as for their clinical team.

Conclusion:

Further education, support, and collaboration with the university could enhance the placement experience for both educators and students and may result in the acquisition of more placement offers. The findings will be used to inform future educator training days as well as widen dissemination of information to all practice placement educators. Further collaboration and effective communication between the university and the educators may promote self-confidence in staff, enhance confidence in student abilities, as well as ensuring that assessment is provided at an appropriate level.

The transition from clinician to academic in nursing and allied health: a qualitative meta-synthesis

OBJECTIVES

The meta-synthesis provides a collective qualitative understanding of the transition experience from nursing and allied health clinician to academic. This understanding assists the preparation for those making the transition as well as giving guidance to those who have recently commenced in academia.

DESIGN

Published qualitative studies about the transition from clinician to academic were systematically selected in order to integrate their findings in a meta-synthesis.

DATA SOURCES

Databases searched were CINAHL, EMBASE, MEDLINE, SCOPUS, 'Education Research Complete', and 'Academic Search Premier'.

REVIEW METHODS

The search terms used were academ* OR facult* AND transition. The search was further refined by adding the terms qualitative AND clinic* OR practit* OR profession*. Studies were appraised for credibility, neutrality and relevance. Findings along with direct quotes were extracted from the studies and thematic analysis was used within an interpretative framework.

RESULTS

Seven studies were included in the meta-synthesis. The included studies were from nursing, physiotherapy, health and social care. The central theme was a shift in identity from clinician to academic which involved a progression through 4 phases over a period of 1- 3years. These phases were; 'feeling new and vulnerable'; 'encountering the unexpected'; 'doing things differently' and 'evolving into an academic'.

CONCLUSION

New academics felt unsettled and uncertain in the initial phases of transition. It is proposed that these challenges are related to difficulty extracting tacit knowledge and immersion in a new culture. The change of values and beliefs to adapt to the new culture require a concurrent identity shift which can take up to three years. Newcomers need collegial and institutional guidance with prioritization of tasks to address the multiplicity of the academic role and avoid frustration and disillusionment.