Continuing Competence and Relicensure

Abstract

The purpose of licensing laws is to provide assurance of high quality service and to protect the public from incompetent practitioners. Safeguarding entrance to the professions by licensing examinations is one part of this responsibility which is entrusted to the professional boards. Assuring the continuing competence of practicing professionals is another part and a major challenge to every board of nursing throughout the United States.

A 1979 mail survey identified 18 states which have specific continuing education requirements for relicensure of nurses. In addition, three states have standards of practice incorporated in the rules and regulations governing the nursing profession.

Mandatory continuing education is a first step in the implementation of a system to assure the public of the continuing competency for practice of the professional nurse. It is acknowledgement, with the force of law, that continuous renewal of knowledge is a necessary condition for assuring competence. However, it is not sufficient in itself. Knowledge must be integrated in performance, which is the final test of competency. Thus, other system components that assure continuing competency must be developed and implemented. These include the identification of standards of acceptable performance, and the development and implementation of measures to evaluate practicing professionals and assure that they meet the performance standards. These measures include peer review, self-assessment, and recertification procedures. Successful implementation of a complete effective system will require the collaborative efforts of practicing nurses, their professional organizations, and the state boards of nursing.     

A survey of occupational therapy in Australian work practice

While the prevention and management of work-related injuries are major areas of practice for Australian occupational therapists, there has been little research on occupational therapy's contribution in these areas. This study examined the characteristics of current Australian occupational therapy practice in the work arena. A postal questionnaire was sent to 355 occupational therapists employed in work practice from six of the eight state or territory Occupational Therapy Associations. The questionnaire enquired about demographic details, service provision in the prevention, assessment and rehabilitation areas and further education needs in these areas. The responses of 125 (35%) therapists were analysed and show the services commonly offered in prevention, assessment and rehabilitation. The most commonly offered services included job analyses, workplace assessment and suitable duties programs. The results also indicate high levels of service provision in the workplace. In presenting the findings of the survey, current trends in international and Australian occupational therapy work practice are discussed along with suggestions for directions in future education, practice and research.     

Competencies and Their Assessment

This article explores competencies and methods for their assessment in higher education and in social work’s accreditation standards. Many contemporary policy and educational accreditation efforts employ the model of competency assessment. The current emphasis on accountability in higher education, including the Council on Social Work Education’s 2008 and draft 2015 Educational Policy and Accreditation Standards, is contextualized through a short history of this movement and its purposes. A multipart definition of competencies is offered based on McClelland’s pivotal conceptualization of competency assessment. Within this competency model, several methods of assessing competencies in social work education are described and critically examined. The importance of identifying an appropriate and complete list of competencies is also addressed. Several issues regarding how to assess professional competencies are identified for future professional discussion.     

Compassion Fatigue,Compassion Satisfaction,and Burnout

Summary

Over the past several decades the mental health field has become increasingly concerned about potential negative effects in professionals of providing crisis intervention and traumatic stress services to individuals and groups. The employee assistance (EA) field has not received adequate attention with regard to the study of these negative effects, such as compassion fatigue. This paper highlights results from a national research study of members of the Employee Assistance Professionals Association (EAPA) who were assessed for risk for compassion fatigue and burnout, as well as potential for compassion satisfaction. Additionally, coping methods for dealing with work-related stress resulting from the provision of workplace crisis intervention services were measured. Findings indicate that EA professionals who provide clinical services and/or crisis intervention services in the workplace are at low risk for burnout, moderate risk for compassion fatigue, and have high potential for compassion satisfaction. Implications for the EA field, in terms of training and practice, are discussed.     

Evaluation of a classroom movement integration training delivered in a low socioeconomic school district

Movement integration (MI), which involves infusing physical activity (PA) into general education classrooms, is an evidence-based strategy within whole-of-school approaches for helping children meet the national PA guideline of at least 60 min per day. This study evaluated an MI training delivered in a low socioeconomic elementary school that had recently invested in three movement facilitative classrooms (a kinesthetic classroom and two activity labs). We investigated (a) the training’s fidelity in meeting recommended best practices for professional development and (b) school professionals’ perspectives of the training. Eight school professionals participated in the study, including five classroom teachers, two activity lab supervisors, and the principal. The researchers used a video of the training to rate the fidelity of the training to best practice recommendations. Interviews, field notes, and informal conversations with participants were qualitatively analyzed for themes. The training received a total fidelity score of 42%. Qualitative findings highlighted participants’ varied perspectives of the training’s purpose, challenges associated with the training and future recommendations for MI trainings. For MI trainings to be a valuable asset in increasing teachers’ value and effective implementation of MI, trainings need to be designed to be in line with best practice recommendations and teachers’ perceived needs.     

Practice Change in Child Welfare: The Interface of Training and Social Work Education

This article examines perceptions of the relationship between professional education and workplace training among a select group of public child welfare employees who pursued graduate social work education during a period of major practice change at their agency. Focus groups were conducted with representative members of graduating cohorts as students completed their studies to explore the connections and distinctions between their professional education and the workplace training that introduced case practice reform. Experienced caseworkers, supervisors, and management-level staff, study participants were well situated to contemplate the changes in process at their agency. They offered insights into the progress of reform and the challenges of sustaining change as well as their roles as professional social workers in carrying reforms forward.     

Juvenile offender rehabilitation in Estonia: interprofessional collaboration in written assessments and specialists’ perceptions

Qualitative and quantitative research methods were used to study an interprofessional assessment model in rehabilitation services and its implementation in Estonia based on (1) a sample of rehabilitation plans for 160 juvenile offenders aged 7–18 and (2) expert interviews with 10 members of an interprofessional assessment team. Each specialist’s role was compared with the assessments. While each team member is assigned a discrete role based on discipline, in practice, the disciplines’ work overlapped considerably during the assessment process. The overlap seems to occur because team members conduct their assessments individually, rather than following the collaborative best practice model for interprofessional teams described in the literature. The expert interviews indicate that rehabilitation specialists perceive the individual-level elements of interprofessional teamwork to be consistent with the ideals articulated in the Perception of Interprofessional Collaboration Model, while the substantial overlap in assessments that occurred in practice could be related to lack of interprofessional collaboration at group and organizational levels. Recommendations to improve the functioning of teams serving juvenile offenders include establishing an interprofessional education system, increasing the flexibility of the legal framework for service provision, and improving the interprofessional assessment instrument.     

A skillset and a stance: Program planning for cultural competence and cultural humility in home visitation

Cultural competence has long been valued in home visitation, with a special focus on adapting home visiting programs to maximize their effects on specific cultures and populations. Critics advocate that traditional cultural competence training focusing on individual, professional skills-building should be replaced by cultural humility approaches that focus on humble engagement of participants. Little is known about how home visiting programs serving broadly diverse populations experience cultural competence and/or cultural humility efforts and initiatives on the ground. Interviews approximately 90−120 min in length were conducted with 34 home visiting program administrators in a large Midwestern state. Interviews were audio-recorded, transcribed, coded thematically, and subjected to content analysis. Two themes were identified from interviews. Respondents emphasized that: 1) cultural competency training was required by home visiting program models, so cultural competency questions were always addressed in home visitation, especially in training for new home visitors; and 2) cultural competence also included many aspects of cultural humility, commitment to continuous self-evaluation and self-reflection on cultural encounters that identified cultural knowledge gaps and sought more information. Respondents did not see cultural competency and cultural humility as oppositional and saw both concepts as important for engaging participants in home visitation.     

Indigenous Women and Professionals’ Proposed Solutions to Prevent Intimate Partner Violence in Tribal Communities

The purpose of this study was to unveil Indigenous women and professionals’ proposed solutions to prevent and ameliorate the disproportionate rates of intimate partner violence (IPV) experienced by U.S. Indigenous women. Reconstructive analysis of interview data from 29 adult Indigenous women who had experienced IPV and 20 professionals who work with those affected by IPV revealed the following themes: (a) increasing community engagement and awareness, (b) bolstering the existing service system, (c) enhancing competency and professional training, (d) child-focused prevention and education strategies, and (e) family-focused interventions. Recommendations provided alternative approaches to ameliorating and preventing IPV in Indigenous contexts.     

The Core Competency Movement in Marriage and Family Therapy: Key Considerations From Other Disciplines

There is a growing movement to define competency within the field of marriage and family therapy (MFT), particularly with respect to the training of practitioners and the evaluation of clinical practice. Efforts to define competency, however, transcend the practice of MFT and much can be learned from the experiences of other disciplines. Professions such as education, law, and medicine have made strides toward addressing the complex issue of competency standards in their respective fields. This article describes some ways in which the issue of competency has been approached in other professions, as well as some common dilemmas posed by adopting a competency-based orientation, to shed light on the process of defining competency in MFT. Moreover, this article identifies some of the more useful conceptualizations, modes of pedagogy, and evaluative practices found in other professions.     

Going beyond training: theory and practice in managing learning

The establishment of new bodies to replace the Central Council for Training and Education in Social Work (CCETSW) and to regulate the social work profession provides the opportunity to establish an improved progressive system of qualifications and continued professional development in the coming years. With the current pressure on social work agency budgets it is imperative that precious training resources—staff and money—are used to make the maximum impact on service delivery. Our involvement in the provision of a range of training programmes leads us to believe that much of the staff development and training effort invested by agencies in their staff often seem to have a limited impact on effectiveness. A change in approach is needed so that learning is placed at the heart of organisational processes to maximise the benefits of affirmation and growing professional confidence. This is essential if we are to continue to ‘nurture’ valuable professional staff and ensure that services remain flexible, creative and responsive in meeting ever‐rising public expectations.

This paper examines some of the challenges of evidence‐based practice and the demands for routine evaluation and objective‐setting. The advantages and disadvantages of a competence specification approach within the development of service and occupational standards as the basis for professional education are discussed. The paper argues that strategies for practice learning require the development of learning organisations and a better academic and agency partnership to support more effective professional education and continued professional development.     

Achieving Collaborative Competence through Interprofessional Education. Lessons Learned from Joint Training in Learning Disability Nursing and Social Work

The ability to work interprofessionally is widely regarded as essential to professional education and training for social work. The changing contexts of social work practice and the requirement for integrated working are regular reminders of the need for social work students to develop collaborative competence. Guidance preceding the development of the social work degree emphasised that social work students should undertake specific learning and assessment in partnership working and information sharing. This suggests that aspects of interprofessional education are relevant to the teaching and development of social work students if graduates are to successfully engage in complex practice.

This paper seeks to identify the competencies needed for successful collaboration. It then draws on evaluative research of joint training programmes in learning disability nursing and social work in England to discuss the unique experiences and perspectives of graduates whose social work training was exceptionally interprofessional. The paper will discuss how some of the findings from this research can indicate lessons for promoting collaborative competence in singly trained social work students. It will argue that interprofessional learning opportunities are one of the key ingredients for the development of critical practice.     

Competency-based program evaluation: A contingency approach

What types and levels of professional competency should an evaluator have? Should requisite competencies differ depending on the nature of an evaluation? Can a practical competency assessment approach be developed for use in educating highly qualified evaluation professionals? This article addresses these concerns by presenting a contingency model of evaluation competencies. Four broad categories of competency — policy analysis, administrative, interpersonal /personal, and technical — are identified along with three different levels or criteria of acceptable performance. Then several features of the evaluation context, including the evaluation type, the phase and the evaluator role, are individually analyzed to determine the required competencies implied by each. Based on this, a contingency model is developed that postulates requisite competency types and levels depending on a combination of contextual features. The article concludes that the model can usefully serve as a heuristic or organizing mechanism for assessing evaluation contexts and orienting the education of professional evaluators.     

Development of an evidence-based conceptual framework for workplace assessment

One solution to the underutilization of workplace accommodations is to use teleconferencing technology to conduct remote assessments, effectively expanding the geographical area that experienced rehabilitation specialists can cover. However, such an effort requires a highly structured and comprehensive assessment protocol. This paper reports on the analysis of 53 existing assessments to develop a conceptual framework for assessment and the use of that framework to evaluate the applicability of 10 work-related assessment protocols for remote tele-assessment. While none of the 10 protocols were found to be sufficiently comprehensive for our purposes, the conceptual framework itself will serve as an important tool to structure a new comprehensive protocol that will be developed. Moreover, the framework can also be used by providers of workplace assessments to evaluate the suitability of any assessment protocol to meet the needs of any particular individual or workplace situation.     

The art and science of teamwork: enacting a transdisciplinary approach in work rehabilitation

Teamwork, collaboration and interprofessional care are becoming the new standard in health care, and service delivery in work practice is no exception. Most rehabilitation professionals believe that they intuitively know how to work collaboratively with others such as workers, employers, insurers and other professionals. However, little information is available that can assist rehabilitation professionals in enacting authentic transdisciplinary approaches in work practice contexts. A qualitative study was designed using a grounded theory approach, comprised of observations and interviews, to understand the social processes among team members in enacting a transdisciplinary approach in a work rehabilitation clinic. Findings suggest that team members consciously attended to a team approach through nurturing consensus, nurturing professional synergy, and nurturing a learning culture. These processes enabled this team to work in concert with clients who had chronic disabilities in achieving solution focused goals for returning to work and improving functioning. Implications for achieving greater collaborative synergies among stakeholders in return to work settings and in the training of new rehabilitation professionals are explored.     

The Use of Religion and Spiritual Strategies in Rehabilitation

Abstract

Recently the helping professions have reopened the debate about utilizing religion or spirituality in both education and practice. In this study, in-depth interviews were completed to identify what, if any, strategies rehabilitation professionals had utilized in practice. Four major themes evolved from participants: (1) denial of having used strategies; (2) use of the concepts for their own benefit; (3) use of the concepts for client benefit; and (4) the use of multiple religious or spiritual strategies. Implications for professional and continuing education are addressed. Lastly, suggestions for future research are highlighted.     

Equity vs. Invisibility: Sexual Orientation Issues in Social Work Ethics and Curricula Standards

The responsibility of the social work profession to be inclusive and equitable in its service provision is reviewed via policies relating to professional training regarding sexual orientation issues. A comparative review of Canada, the United Kingdom (UK) and the United States of America (USA) and international standards regarding sexual orientation issues in social work codes of ethics and curricula standards was undertaken. A consistency exists in the USA between its ethics code and curriculum standards further backed by a mandated approach, but it is weak in the area of ethically principled practice skills. Both Canada and the UK are less consistent and comprehensive and lack a mandated approach. The results speak to where consistencies exist and where they need to be established in order to develop an infrastructure that properly trains social workers in cultural competency for these populations.     

Validity of work-related assessments

Insufficient evidence of the validity of work-related assessments is frequently reported as a major concern in occupational rehabilitation. Despite this concern, and the continuing development of new and old assessments, no comprehensive evaluation of the evidence has been conducted. OBJECTIVES: The purpose of this study was to first determine the extent and quality of available evidence for the validity of work-related assessments, and then where sufficient evidence was available, determine the level of validity. STUDY DESIGN: This study examined available literature and sources in order to review the extent to which validity has been established for 28 work-related assessments. RESULTS: The levels of evidence and validity are presented for each assessment. Most work-related assessments have limited evidence of validity. Of those that had adequate evidence, validity ranged from poor to good. There was no instrument that demonstrated moderate to good validity in all areas. Very few work-related assessments were able to demonstrate adequate validity in more than one area, or with more than one study, even when contributory evidence was included. CONCLUSION: With this study clinicians will be able to examine their options with regard to the validity of the assessments they choose to use.     

International English and ergonomics: a romance in the making?

This paper argues that it would be useful for ergonomists and experienced English Language Teaching (ELT) professionals to collaborate as this would be of substantial interest to both sets of professionals. The ongoing debate in ELT on International English (IE) might usefully help to guide ergonomists if and when they require to judge that English is used at appropriately high levels in the workplace in non-English speaking countries. It may also help ergonomists who are non-native speakers (NNSs) of English to gain greater access to the top specialist journals and to found new e-journals on Ergonomics in English that deserve international recognition. At the same time ELT specialists would have great interest in advising ergonomists on these matters, in part, as a means of testing current hypotheses on the tendencies for new varieties of English to develop and win acceptance both from native and non-native speakers of English as setting standards of communicative competence in English both for end users of English in their professional lives and for well-structured and clear written academic debate.