Therapy Project Office. Framework for Practice Educator Training & Education Needs Practice Educator Training Needs & Training Needs Analysis

Transcription

1 Therapy Project Office Framework for Practice Educator Training & Education Needs Practice Educator Training Needs & Training Needs Analysis 2008

2 THERAPY PROJECT OFFICE...4 EXECUTIVE SUMMARY...5 INTRODUCTION...6 SECTION ONE...7 Educating the Educators: The Importance of Practice Education for Professional Practice The Roles of Practice Educators... 9 The Goals of Practice Educator Education and Training SECTION TWO Multidisciplinary Practice Educator Competencies Introduction Competency and good Practice Guidelines Survey of current HEI Practice Educator training in Ireland Introduction Aim Methodology Current training in Ireland Survey of Current Practice Educator Learning and Learning Needs SECTION THREE...29 Section Three Introduction Development of the Practice Educator Proposed Delivery of Practice Educator Education and Training Competencies Addressed by the Current HEI Practice Educator courses Proposed Course Content Part 1: Multidisciplinary Topics Part 2: Therapy Course Specific Topics Part 3: Profession Education Topics Proposed Course Delivery Part 1: Multidisciplinary International Examples Part 2: Therapy Course Specific Topics Part 3: Profession Education Topics MULTIDISCIPLINARY PRACTICE EDUCATION FRAMEWORKS...37 Recommended Irish Practice Educator Framework

3 Recommendations for Implementation of this Framework REFERENCES...44 APPENDICES...46 Appendix Glossary Appendix Questionnaire A Appendix Questionnaire B Methodology for Questionnaire B Appendix Table of competencies aligned with content of current courses

4 Therapy Project Office The Therapy Project Office was established in January 2007 to progress and initiate project activities on behalf of the National Implementation Group (NIG) for Clinical Placement Provision for Occupational Therapy, Physiotherapy and Speech and Language Therapy. The projects related to a number of key actions identified by the The Report of the National Planning Group on Clinical Placement Provision for Occupational Therapy, Physiotherapy and Speech and Language Therapy (2004), under the three broad areas of: Practice Education Continuing Professional Development Quality Information for the Public. The Therapy Project Office was funded by the HSE and staffed by three project managers, representing the professional bodies of the Association of Occupational Therapists of Ireland (AOTI), the Irish Society of Chartered Physiotherapists (ISCP) and the Irish Association of Speech and Language Therapists (IASLT). A collaborative, project management model was applied throughout the process. The Project Managers also worked in partnership with the Higher Education Institutes, Therapy Services, the Department of Health & Children and the Health Service Executive to build on existing work and to drive the projects forward. 4

5 Executive Summary The aim of this project was to identify training needs for Practice Educators across the three professions of Occupational Therapy, Physiotherapy and Speech and Language Therapy and to recommend an educational framework to meet these needs. To achieve this aim, two surveys on current Practice Educator training and training needs were carried out with relevant stakeholders. Practice Educator competencies were devised in conjunction with representative groups from the HEIs and Therapy Managers. Drawing from a review of the literature and international examples of best practice, the development of an educational framework for Practice Educators is proposed as offering a valuable contribution to the overall quality in health care provision. The proposed framework endorses a staged, developmental approach to provide a continuum of learning for Practice Educators. This is seen as enhancing and developing learning from novice Practice Educators to expert Practice Educators level. The Irish practice education teams are viewed as key players in the development of Practice Educator competencies and in the delivery of an education and training framework for Practice Educators. The potential for developing Practice Educator education on a multidisciplinary basis is also strongly recommended. 5

6 Introduction The aim of this project was: to identify training requirements for Practice Educators across the three professions of Occupational Therapy, Physiotherapy and Speech and Language Therapy. In order to achieve this aim the following objectives were outlined: Review literature and international examples of best practice Identify multidisciplinary Practice Educator (PE) competencies in collaboration with the Higher Education Institutes (HEIs) and other stakeholders which could inform the development of a training and education framework Identify what training is currently provided for Practice Educators within the practice education system (HEIs) Identify what Practice Educators on the ground identified as their learning needs to become competent Practice Educators Identify the gap between current training and the competencies needed Identify an appropriate education framework with recommendations for implementation. This report is divided into three sections: Section one looks at current literature and outlines the importance of Practice Educator training not only for practice education of therapy students but also for enhancing the quality of professional practice. Section two outlines the results of: The multidisciplinary Practice Educator competencies which were identified as part of the collaborative work that took place between the Therapy Project Office, HEIs and other relevant stakeholders. The survey of current HEI Practice Educator training in Ireland, across all of the Therapy Courses in the Republic of Ireland. The survey of Practice Educator learning and learning needs across the three professions. Section three outlines discussion and recommendations from sections one and two, linking them to current practice both here and abroad and outlines a framework and recommendations for practice education training and education within the Irish context. 6

7 Section One Educating the Educators: The Importance of Practice Education for Professional Practice. Following the publication of the Bacon Report (2001) and on foot of the recommendations therein, additional professional educational courses for the three professions of Occupational Therapy, Physiotherapy and Speech and Language Therapy were developed to augment the supply of therapists to the expanding Health and Disability Sectors. With this came an increasing demand to accommodate therapy students on practice education placements. Guided by the Action Framework of the subsequent Report of the National Planning Group on Clinical Placement Provision for Occupational Therapy, Physiotherapy and Speech and Language Therapy (2004) a National Implementation Group, representing all the stakeholders, has been working collaboratively to put structures in place to support Practice Educators who are providing these practice education placements, and also develop quality initiatives around it. One such structure has been the establishment of the new practice education teams in the Republic of Ireland. These new support teams consist of Practice Education Coordinators (PECs) 1, Practice Tutors (PTs), and Regional Placement Facilitators (RPFs). These new roles when working within a practice education team have responsibility to link onsite practice education with the HEIs and are also the primary support for the Practice Educators on the ground as they take students. The action framework also identified a need for a professional education and training structure to support Practice Educators in their role. According to Higgs (2005) such an education and training structure will have a two fold benefit. It will improve the quality of practice education on the ground and also develop the skills that therapists need professionally for providing, managing and developing quality services. Therefore according to Higgs (2005) the role of Practice Educators as professional supervisors and mentors is important in not only the development of practice education but also in the transformation and improvement of quality in professional practice. Higgs goes on to propose that the development of a strong Practice Educator education training structure will have benefits for all involved in the practice education process and will contribute to producing: 1 For a glossary of all terms used in this document, please see Appendix 1. 7

8 Students who will enthusiastically and with vision become the next generation of practitioners Educators and mentors (including the Practice Tutors, Regional Placement Facilitators and Practice Education Coordinators,) who will not only shape the student s path but who will become transformed in the process themselves Practice Educators who, through their learning experiences, are actively engaged in transforming practice and themselves The managers who provide placements being more able to balance service delivery and practice education within the wider organisational context Consumers and clients of the practice whose needs and requirements are the main drivers for change in practice. Therefore the role of practice education and the support for it is not only of paramount importance for the education of undergraduate and post graduate students, but also for the development of the professions and the overall Health Service. This argument is supported by Cross et al (2006) stating that: The future of any healthcare profession is largely dependent upon the quality of the learning opportunities it provides for future generations of practitioners as they work towards professional registration, and also for its qualified membership as they continue to enhance and develop their professional knowledge and skills Cross et al (2006:15) In reviewing other literature, McAllister and Lincoln (2005:1) found that practice education and the experience of having students offered opportunities to both educators and students for professional growth and that this professional growth and development implied a movement along a continuum of professional skills and competencies. According to Dreyfus and Dreyfus (1984) this continuum is one of moving from novice to expert status, an acknowledgement that the role of the Practice Educator is constantly changing and evolving. McAllister and Lincoln (2005) refer to four stages of Practice Educator professional growth, drawing on work done previously by Dreyfus and Dreyfus (1986), Brenner (1984) and by McAllister (2001). According to this the stages of development in being a Practice Educator are: Novice educator Advanced beginner Practice Educator 8

9 Competent Practice Educator Professional artistry as a Practice Educator. (McAllister and Lincoln s stages of Practice Educator development work is elaborated on in detail in section three). This evolution in the Practice Educator role is achieved through the knowledge gained with hands on experience of facilitating students and is underpinned by education and reflection in practice education. It should also be noted that an alternative stage for the Practice Educator is acknowledged by McAllister and Lincoln (2005), that being one of burnout. It is referred to as a stage that should be acknowledged but which can certainly be avoided by development of personal and interpersonal skills though Practice Educator education. The Roles of Practice Educators. There are many different tasks and roles required of Practice Educators to operate as competent and organised Practice Educators and to respond to the varied needs of students. The teacher as manager model as described by Romanini and Higgs (1991) outlines the three stages of clinical placement as: Preparation Implementation Evaluation. According to Romanini and Higgs (1991), Practice Educators have five roles when becoming learning programme managers. They are: Task manager Group manager (if there is more than one student present) Individual development manager Environmental manager Overall programme manager. Other authors have expanded these roles to include those of role-model, colleague, teacher, evaluator, administrator, counsellor, and finally researcher. (McLeod et al.1997). In the Irish context the Practice Educator is supported to fulfil these varied roles by the members of the practice education team. All of these are an extension of the skills and roles required of the therapist in the day to day clinical environment. Thus any Practice Educator training will enhance the competencies and skills that a therapist needs in managing both clinical and managerial responsibilities. 9

10 The Goals of Practice Educator Education and Training. According to McAllister and Lincoln (2005) the provision of education for Practice Educators must meet the following goals: Continuous development of clinical knowledge and skills From the point of view of the Practice Educator this is the continuous development of clinical expertise (clinical knowledge and skills) and the development of professional artistry as a Practice Educator. This professional artistry as a Practice Educator as first discussed by Fish and Cole (1998), is described by McAllister and Lincoln (2005) as a Practice Educator who has mature ethical and clinical reasoning and who can then explain and impart this clinical knowledge and reasoning to students. Fish and Twain (1997) also see this professional artistry as quality coming from deepening insight into one s values, priorities and actions. McAllister and Lincoln (2005) see professional artistry in this light, coupled with experience and commitment to development and growth as a Practice Educator. The goals for Practice Educators when developing these skills would be: o Development of clinical expertise o Development of professional artistry as a Clinical (Practice) Educator. Development of knowledge and skills in education Practice Educators need to develop knowledge and skills in education in order to do their job effectively. These skills are first developed by the Practice Educator when they are a student completing practice education placements and then developed further as therapists when they engage with students during practice education. In the clinical environment, a therapist is not only educating students but also educates patients, families, peers and members of the multi-disciplinary team. Therefore educational skills are paramount in a Practice Educator s skill set. The goal for a Practice Educator when developing this area would be: o Gaining skills and knowledge in practice education models and techniques. Development of personal and interpersonal knowledge and skills In order to have effective and satisfying interactions with colleagues, patients, and students, Practice Educators need to have personal knowledge and skills and excellent interpersonal communication skills (McAllister and Lincoln 2005:18-24). 10

11 The goals for Practice Educators in the development of these skills would be: o Extension of self-knowledge and self-awareness o Extending counselling skills into the area of clinical education o Developing awareness of one s need for control o Extension of time management abilities. Development of cognitive skills Clinical practice and all elements of the Practice Educator role involve using different types of knowledge alongside the application of reasoning skills (both ethical and clinical). In order to achieve this, the goals for Practice Educators when developing this competence would be: o Articulating both clinical and ethical reasoning processes o Articulating professional knowledge o Identifying different types of knowledge used in the clinical reasoning process. McAllister and Lincoln (2005:2-8) In conclusion the literature would suggest that a strong framework for Practice Educator training and continuing education is not only a necessary driver for quality practice education placement learning experiences for student therapists, but it is also a driver in promoting quality throughout the therapy profession. Such an educational framework should focus on the knowledge, skills and behaviours that a therapist has to fulfil in their role as a Practice Educator. It should particularly focus on the development of clinical, educational, interpersonal and cognitive skills. 11

12 Section Two. Multidisciplinary Practice Educator Competencies Introduction The first step in developing a framework for learning and education required the identification of the skills and competencies needed by Practice Educators. As part of the work of the Therapy Project Office (TPO), three separate teams of the Practice Education Co-ordinators (PECs) (or other nominated individual) from the courses of Occupational Therapy, Physiotherapy, and Speech and Language Therapy were brought together under the respective project manager to work on practice education projects. As part of that work these three teams devised and ratified multidisciplinary Practice Educator competencies. These were then ratified by three professional manager teams working with other TPO projects. These competencies form a framework which should be used by Practice Educators to help them identify their own educational and learning needs in their professional role, and to guide their own CPD in the area of education and development. Competency and good Practice Guidelines Competencies can be defined as personal traits, characteristics or skills which can be shown to be directly linked to effective performance. (Boyatzis 1982) 1 This competency framework also includes guidelines for good practice to aid in achieving the competencies. They should also facilitate Practice Educators in recognising their achievement of individual competencies. The multidisciplinary Practice Educator competencies are divided into the five areas of: Educational competencies Assessment / evaluation competencies Professional practice competencies Supervision competencies Management and administration competencies A full outline of the Practice Educator competencies and corresponding good practice guidelines are included below in Tables As quoted in the OHM HSCP competencies. 12

13 Table 1: Education Competencies The Practice Educator demonstrates the ability to: Competencies Guidelines for Good Practice Understand learning styles Understand individual differences in processing and learning styles Apply knowledge of learning styles to student practice education processes Demonstrate familiarity with learning styles and an understanding of how ones own learning style interacts with other learning styles Understand models of practice education Understand a range of models of practice education. E.g. 1:1 model, 1:2 peer learning model, group etc. Show an understanding of teaching styles, such as reflective learning, problem based learning etc. Create a positive learning environment for students Structure the placements to optimise student learning while maintaining a quality service to clients Use all available resources to promote the student s professional development Table 2: Supervision Competencies The Practice Educator demonstrates the ability to: Competencies Guidelines for Good Practice Educate, monitor and mentor students Establish and maintain an effective working relationship with the student Present clear performance expectations initially and throughout the placement appropriate to level of practice Organise initial planned learning; goal setting and be able to re-evaluate in collaboration with the student Identify students competency level, learning goals and supervision needs Prepare the student as appropriate for clinical practice Assess and identify each individual student s supervision needs Anticipate and prepare student for challenging situations as appropriate Match student competency levels to direct and indirect clinical demands 13

14 Table 3: Assessment/Evaluation competencies The Practice Educator demonstrates the ability to: Competencies Guidelines for Good Practice Assess the student fairly Use the student assessment tool accurately to measure student s performance based on objective information (e.g. direct observation, discussion with student, review of student s documentation etc.) Encourage student development and learning Involve and encourage the student in self reflection and self assessment using formal and informal evaluation sessions Use evaluation processes to counsel students on strengths and opportunities for development Table 4: Professional Practice competencies The Practice Educator demonstrates the ability to: Competencies Guidelines for Good Practice Develop all clinical practice skills of the student Assist students in developing and refining clinical practice skills in conjunction with the Practice Education Team Facilitate the development of clinical reasoning Demonstrate strong clinical reasoning Facilitate effective clinical reasoning in students Guide student s integration of theory and practice Guide student s integration of therapeutic concepts and skills, and encourage reflective practice Facilitate documentation skills Use documentation format and requirements in accordance with local and professional guidelines Demonstrate an ability to train students in the use of clinical recording processes Incorporate legal, ethical and professional issues that influence practice Implement legal and professional guidelines that influence practice (e.g. confidentiality, role delineation etc.) Implement the philosophies, policies, protocols and clinical guidelines of the service provider 14

15 Adhere to professional practice standards and the code of ethics of the professional association Deliver service in line with professional standards of practice and the professional association guidelines Maintain own CPD in the area of practice education Assume responsibility for, and pursue professional development to expand knowledge and skills Be a model of professional conduct and behaviour Demonstrate appropriate professional conduct and behaviour at all time Table 5: Management/Administration competencies The Practice Educator demonstrates the ability to: Competencies Guidelines for Good Practice Communicate and collaborate with the practice education team Establish effective communication links with the practice education team when appropriate Induct student effectively Provide pre-placement information to facilitate advance student preparation Provide complete orientation of student to placement site Inform student of mission, goals, philosophy and standards of organisation / service Set out an organised and systematic placement programme Manage time effectively Effectively balance own caseload and the student s learning needs Manage own time efficiently and encourage student in developing time management skills Complete and distribute in a timely manner all student evaluations, including but not limited to the mid / final evaluation Develop student clinical management and prioritisation skills Assist the student in developing and refining clinical management and prioritisation skills Implement quality improvements Encourage ongoing evaluations of the student s placement / education along with the practice education team Modify placements based on feedback / evaluation 15

16 Survey of current HEI Practice Educator training in Ireland. Introduction Following the developing of Practice Educator competencies, the current level of Practice Educator education and training was explored. Aim A survey was carried out with the aim of collecting information on the Practice Educator courses that are currently being provided by the HEIs in the Republic of Ireland. Methodology In order to collate this information Questionnaire A (Appendix 2) was sent to the Practice Education Co-ordinators (PEC) of each of the courses of Occupational Therapy, Physiotherapy and Speech and Language Therapy in the Republic of Ireland. As some of the courses did not have a PEC in situ at the time, the Department Head was asked to nominate another staff member to responds to the questionnaire. The data was a mix of qualitative and quantitative data, and any clarification (if needed) was obtained by a follow up phone call to all concerned. Current training in Ireland General From the questionnaire it was clear that all Therapy Courses are providing practice education and training for Practice Educators who facilitate their students on placements. The majority of the Therapy courses provide training as annual education days on practice education topics that are requested formally via feedback forms etc. or informally by the Practice Educators. Most of these courses are organised and run by the Practice Education Co-ordinators in conjunction with the Practice Tutors and Regional Placement Facilitators and generally are run as uni-disciplinary courses for their own Practice Educators. Most Therapy courses provide this annual training / education on a first come first served basis and also use this forum to identify any further Practice Educator education needs. 16

17 The topics covered in these courses change each year and there is no formal follow-on through the courses. Recently, courses have being changing this practice and some of the new Therapy Courses have had a different structure in place from the onset. They are aiming to run courses each year at both basic and intermediate/advanced level. The basic Practice Educator course would repeat common themes whereas the topics on the intermediate /advanced one day course change to meet the needs of the more senior Practice Educators. For a broad outline of Practice Educator training provided see Appendix 2. For an outline of the topics covered in these Practice education and training days see Tables 6, 7 and 8 below for each therapy course under the three disciplines. Table 6: Content of the current HEI Physiotherapy Practice Educator courses Physiotherapy Practice Educator courses TCD UCD UL Basic RCSI & Adv Supervision principles and responsibilities * * * Communication skills * * Assessment skills, form, pass / failing criteria. * * * Learning styles * * * * Teaching methods * * * * Coaching and mentoring * * * Giving feedback * Peer learning * Dealing with underperforming / excelling * students Clinical and EBP updates * * Creating a positive learning environment * Learning contracts & objective setting * Curriculum- practice education components * HEI policies and procedures for PE * University philosophy * * Table 7: Content of the current HEI Speech and Language Therapy Practice Educator courses Speech and Language Therapy Practice TCD UL NUIG UCC Educator courses Supervision responsibilities * * * * Communication skills * * * * Assessment skills * * * * 17

18 Criteria for passing and failing students * * * * Learning styles * * * * Teaching and learning methods * * * * Coaching and mentoring skills * * * * Course structure and education programme * Information regarding college systems * Problem solving and contracting skills * Feedback and problem-solving * Overview of curriculum * Problem-based learning. * Table 8: Content of the current HEI Occupational Therapy Practice Educator courses Occupational Therapy Practice Educator courses TCD UL NUIG UCC Supervision responsibilities * * * * Communication skills including feedback skills * * * * Assessment skills and use of assessment tool * * * * Criteria for failing & passing students * * * * Learning styles * * * * Teaching & learning methods * * * * Coaching and mentoring * * * The curriculum and students learning * * Different models of supervision. * * Clinical teaching skills * Input from students on their experience of PE * * Setting learning objectives * * Use of a learning contract * * Giving and receiving feedback * * Multi-disciplinary More recently, Colleges have started running regular multidisciplinary Practice Educator courses. The University of Limerick (UL) provides a multidisciplinary programme for its Practice Educators. They run a one day basic multidisciplinary course that covers topics such as adult education, learning styles, giving feedback, developing communication skills and coaching the student etc. This course is run biannually for therapists from all three disciplines who wish to take students or are currently taking students. 18

19 The College also runs an advanced one day course for therapists once they have completed the basic course. The course content changes from year to year and is based on feedback from Practice Educators. Topics include supervision, communication skills, assessment skills, criteria for passing and failing students, learning styles, teaching and learning methods and coaching & mentoring. In parallel with this each of the three Therapy Departments also run a single disciplinary course for Practice Educators. Course content would cover such topics as the college curriculum, the use of assessment forms, supervision policies and procedures around the practice education of students which may be unique to that individual course. The National University of Ireland Galway (NUIG) has also a multidisciplinary course for Practice Educators from Occupational Therapy and Speech and Language Therapy. The areas covered in this course are assessment processes, giving and receiving feedback etc. delivered over three days by an external lecturer. The structure of this course is developmental in that Practice Educators must complete day 1 before they can move to day 2 and must have completed the first two days before progressing to day 3. This has been delivered twice to date and on both occasions feedback has been positive. Funding has now been confirmed to continue this course over the next three years. The multidisciplinary element in particular came in for a lot of praise. Practice Educators enjoyed the sharing of ideas and the development of a support network of Practice Educators outside the constraints of professional boundaries. As the Irish Health Care system evolves it is seen that it is important to have a multidisciplinary attitude to Practice Educator support. This approach promotes the development of informal networks and that the all important support / input of colleagues which was identified by therapists as a key way of developing Practice Educator competency can be extended to include colleagues in other disciplines. As part of Practice Educator training, the Department of Occupational Therapy in University College Cork (UCC) runs a two day single discipline Practice Educator workshop. As a follow-on to this they support those educators who are interested in studying further to do two modules from the faculty s multidisciplinary Masters in Advanced Healthcare. These two modules are: Thinking, reasoning and reflective practice Educating for professional development in practice. If a Practice Educator completes the UCC two day workshop and these two specified Master modules they become an Accredited Practice Educator. Practice Educators can 19

20 also gain transferable credits for these two modules, and if they wish to proceed with further education they can complete the full Masters programme or progress to doctorate level. Post Graduate Courses Following on from the example of UCC, other Therapy Courses are also linking practice Educator education in with their post graduate programmes. In NUIG the Occupational Therapy and Speech and Language Therapy Departments link in with the University s post graduate Diploma in Clinical Education which is co-ordinated by the School of Medicine. This post graduate course is open to all health care professionals and offers Practice Educators a diploma and masters option if they wish to take their practice education training further. New Developments Up to this year the Physiotherapy Department in University College Dublin (UCD) has run a standard one day Practice Educator workshops as outlined earlier. Currently a programme in clinical education is being developed in conjunction with the Centre for Teaching and Learning. It is planned to roll out this course over the academic year of The course will include induction days outlining the practice education procedures and policies for practice education placements. After participating on these induction days, Practice Educators may wish to then carry on to the certification or diploma course. The induction days would count for credit towards these post graduate courses. The plan is to offer this as a two year post graduate diploma. After the first year a Practice Educator can obtain a post graduate certificate and after completing year two, they can achieve a post graduate diploma. The structure is that there would be a combination of lectures, problem based learning, on-line learning and group work. The focus in each semester would vary from emphasis at first on teaching, learning theories and assessments in semester one to models of supervision and their assessment in semester two. Competencies, expectations and becoming a reflective practitioner would be looked at in more detail in year two. At present this new programme is still in the planning stage but should have final sign off to run in The plan is to have the first year of the programme specifically aimed at Practice Tutors (who are recently in post). It is hoped that the following year the same 20

21 module will be open to all Practice Educators or members of the extended practice education team as the standard Practice Educator education programme for the Physiotherapy Department in University College Dublin. All educational days and modules completed will have European Credit Transfer credits assigned. These can then be carried and added to credits for Higher Diplomas or Masters if a Practice Educator wishes to do so. Other Educational / CPD opportunities offered All of the HEIs are involved in the organisation and provision of continuing professional development (CPD) opportunities and professional support for therapists which are not directly related to practice education. For example, clinical updates and evidence based practice opportunities that are offered to therapists to develop their clinical skills in recognition for their contribution to the practice education of students. In Occupational Therapy the four courses also offer a range of CPD courses and opportunities for practicing therapists. These to date have covered such areas as evidence based practice, reflective practice, designing learning environments, clinical reasoning Occupational Science, models of Practice, Reading, writing and engaging in research, report writing, opportunities to attend student research presentations, practice skills and educational facilities for university staff to provide customised onsite teaching and learning supports. The Physiotherapy Department in Trinity College offer other CPD opportunities not directly related to practice education such as on site in-service training. The Physiotherapy Department in the Royal College of Surgeons (RCSI) offer Practice Educators access to library, e-journals and online databases. The Physiotherapy Department in the University of Limerick offer a number of clinical study days, a research seminar and a student final year project poster presentation day. Some courses offer Practice Educators a chance to lecture on the undergraduate course, and to give practical demonstrations / lectures also. In Speech and Language Therapy the individual colleges offered workshops and study days on various topics relevant to the profession. 21

22 HEI methods of identifying Practice Educator training needs The identification of training needs is done in a variety of different ways by all of the disciplines. Some send out surveys to their Practice Educators, managers and tutors. Currently in Occupational Therapy, the main method of identifying the learning and education needs of Practice Educators is via direct communication with the Practice Eduation Co-ordinators and with the other members of the practice education team. Site visits were particularly mentioned. Course evaluation forms and feedback questionnaires are also used. The Occupational Therapy Department in Trinity College have put a partnership committee in place at which the views and needs of Practice Educators can be articulated. In Physiotherapy, needs are identified formally through questionnaires before during and after Practice Educator courses and study days, and informally through discussions with Practice Educators, Practice Tutors, Regional Placement Facilitators, placement provider managers, students etc. In Speech and Language Therapy, Practice Educator s training needs are currently identified through feedback questionnaires, annual supervisory meetings, through Clinical Steering Committee or through feedback from Speech and Language Therapy line managers. 22

23 Survey of Current Practice Educator Learning and Learning Needs Introduction After having devised Practice Educator competencies and collecting information from the HEIs on all the Practice Educator education and training provided, the next step was to get feedback from the Practice Educators themselves. Aim The aim of this survey was to identify Practice Educators current level of Practice Educator education and training and to elicit their views on their own education and training needs. Methodology In order to identify what Practice Educators identified as their learning needs, questionnaire B (see Appendix 3) which was made up of mostly open ended questions was sent to a sample of Practice Educators across the three disciplines of Occupational Therapy, Physiotherapy and Speech and Language Therapy. The total response rate was N= 258 (see Appendix 4 for further break down of methodology). Results Profile From the sample in this survey, it is found that the majority of therapists taking students are a minimum of five years qualified (81%). This profile was similar across the three professions (see Table 9 below). Table 9: How many years of practice have you completed? % < >10 Did not answer years years years years OT 7% 15% 40% 38% 0% PT 0% 16% 46% 35% 4% SLT 0% 14% 47% 38% 2% 23

24 Practice Educators were asked how many years they had been taking students. The results indicated a relatively even spread of those with a small amount of experience up to those with more than 10 years experience of having taken students (See Table 10 below). Table 10: How many years have you been taking students? % < 2 years 2 4years 5 10years > 10years Did not answer OT 26% 28% 24% 19% 2% PT 19% 39% 28% 11% 4% SLT 18% 26% 36% 20% 0% In this survey Practice Educators were asked to give the number of HEIs that are offered practice education placements by their department / service. This is relevant as different HEIs offer different training courses and may have different requirements for their Practice Educators particularly with regard to student assessment. 51% of Physiotherapy Practice Educators surveyed take students from just one college with 45% taking students from 2 or more colleges. In Occupational Therapy 37% of Practice Educators take students from one HEI with 61% taking from two or more HEIs. In Speech and Language Therapy, the figures are similar with 36% taking from one HEI and 63% taking from two or more. (See Table 11 for further break down below). Table 11: How many HEI s does your department provide placements for? % 1 HEI 2 HEIs 3 HEIs 4 HEIs 5 HEIs 1 Did not answer OT 37% 36% 20% 5% 0% 2% PT 51% 26% 5% 5% 9% 4% SLT 36% 38% 17% 8% 0% 1% What is Essential Learning for Practice Educators? The respondents were asked what they considered to be essential learning for a Practice Educator. The main areas that were listed are: Knowledge of course structure and curriculum Student assessment 1 There are currently only 4 courses of Physiotherapy, Occupational Therapy and Speech and Language Therapy in the Republic of Ireland. The resources and structures discussed in this document are only there to support the students from these colleges. Any students taken from outside this jurisdiction are at the discretion of the placement provider and fall outside these resources and structures. 24

25 Teaching skills Good communication The ability to manage feedback. Further responses are outlined in Table 12 below. Table 12: What do you consider to be essential learning for a Practice Educator? (The top three for each profession are in italics) OT% Physio% SLT % Knowledge of course structure and curriculum Student assessment procedures Supervision skills Teaching skills Current evidence based practice through CPD HEI Expectations of the placement Giving / receiving feedback Learning / teaching styles Managing a weak / excelling student Goal / objective setting for placements Communication skills Personal knowledge, experience or competence in the training area Time management skills How to handle conflict / difficult situations Problem based learning skills In addition to these essential areas of learning, Practice Educators were asked to list what other elements would contribute to their competency. These elements included: Further evidence based practice (EBP) updates and advanced clinical courses Information on learning contracts The Practice Educators also list getting further experience with students as a contributing factor to developing their competency, along with access to more resources and further support from peers and HEIs. Student Assessment Information relating to student assessment forms and competence in student assessment was identified by therapists as being essential learning for a Practice Educator. As seen 25

26 already, a high percentage of Practice Educators across the professions take students from more than one HEI and therefore need to be competent in the use of more than one assessment form. This is not necessary in Physiotherapy as a common assessment form has been developed by the four HEIs. This form is currently being piloted. As part of the work of the Therapy Project Office, a common assessment form has been agreed across the four disciplines of Speech and Language Therapy which will be piloted in Spring The questionnaire sought to identify if the Practice Educators had been trained in all student assessment forms that they use. Chart 1: Training in Assessment Forms Used 1 Assessment Form Training % of Therapists All Forms Some Forms No Forms Did not answer OT PT SLT Across the three professions, less than 50% of Practice Educators are trained in administering all the forms they use. (Chart1: Occupational Therapy = 64%, Physiotherapy = 51%, Speech and Language Therapy = 24%, Multidisciplinary = 49.3%). This result may be influenced by the small number of practice education placements that are provided to students from a HEI outside of the Republic of Ireland. Even so this lack of consistency in training has obvious implications for maintaining the standard and quality of assessment using these forms. However, despite inconsistent training in the use of assessment forms the majority of therapists surveyed reported feeling confident completing a student practice education assessment form (Occupational Therapy: 75%, Physiotherapy: 80%, Speech and Language Therapy: 60%). 1 Please note that despite the fact that there is now one common practice education assessment form in Physiotherapy it was only being implemented when this survey was sent out (May 2007). Up to then Physiotherapists were still using the four separate forms and this is reflected in the answer to this question. From September 2007 one form is now used. 26

27 Training in Practice education models Over the past number of years a lack of capacity in practice education placements has led to requests for Practice Educators to take more than one student at a time. It would appear that the experience of taking more than one student at a time is more prevalent in Speech and Language Therapy with 65% taking more than one student at a time (see chart 2). This is closely followed by Physiotherapy with 51% and finally OT at 25%. Chart 2: Have you as a Practice educator supervised more than 1 student at a time? % of Practice Educators Yes No Did not answer OT STL Of the therapists who have supervised more than one student at a time (those who had answered yes in Chart 1), the majority reported that they have not been trained in the peer learning, or 2:1 model, (Occupational Therapy = 85%, Physiotherapy = 69%, Speech and Language Therapy = 56%). See Chart 3. Chart 3: Have you as a Practice Educator been trained in peer learning / 2:1 model or any other peer learning model Trained in Peer Learning / 2:1 Model % of Therapists 80 No Yes Did not answer OT PT SLT 27

28 Other ways of developing competency When Practice Educators were asked what other ways of learning had been beneficial in developing and maintaining their competency, Input / support from colleagues was identified by a large percentage of therapists across the three professions. In addition, being supervised, and maintaining CPD were also mentioned (see Table 13.) Table 13: Aside from attending a university lead course what ways of learning / other courses have been beneficial in developing and maintaining your competency as a Practice Educator? OT% PT% SLT % Input / support from colleagues Being supervised and getting feedback CPD Working with and within the MDT In-services Experience or knowledge Supervising others Feedback Other courses or group meetings attended

29 Section Three Section Three Introduction The aim of this report was to identify competencies and training requirements for Practice Educators, across the three professions. The discussion that follows below, draws on the information gathered in the two surveys and reviews it in relation to the Practice Educator competencies and current literature on education and training for Practice Educators. Based on this review, a framework for Practice Educator education and training in Ireland as recommended by the Therapy Project Office is outlined. This is followed by recommendations for the implementation of such a framework. Development of the Practice Educator McAllister and Lincoln (2005) as discussed already, outline that the provision of education for Practice Educators must meet the following goals: Continuous development of clinical knowledge and skills Development of knowledge and skills in education Development of personal and interpersonal knowledge and skills Development of cognitive skills. (McAllister and Lincoln (2005:2-8) They also refer to four stages of Practice Educator professional growth: Novice educator Advanced beginner Practice Educator Competent Practice Educator Professional artistry as a Practice Educator. Within this developmental framework, the role of the Practice Educator is constantly evolving. This evolution in the Practice Educator role is achieved through the knowledge gained from hands on experience with students and is underpinned by education and reflection. The education and reflection needs of Practice Educators at the various levels are very different and should be supported accordingly for each level. 29

30 Proposed Delivery of Practice Educator Education and Training As outlined earlier in this report, the standard structure for practice education has been a once or twice yearly educator day, with topics varying. A systematic approach which allows for a progressive continuum along which to develop these skills is called for. This is instrumental for the development of educators from novice to expert. With the development of the Irish practice education structure and the current practice education teams there now exists the potential to address Practice Educator education and training needs in a more structured and organised way, at Department level, HEI level, and regional and national level. Even since the authors began collecting the information for this report (from January to November 2007) there has been a new wave of courses developed by the various Therapy Courses. As reviewed earlier, examples of this progression have been mentioned where the various HEIs have begun to address the issue of a staged and structured delivery of educational provision for Practice Educators. Taking this one step further to a more regional and nationally coordinated level would see enormous economies of scale. A closer look at the various topics delivered in the current courses and analysis of how they could be structured and rolled out in a different manner at a number of levels allows us to see how this could be achieved. Competencies Addressed by the Current HEI Practice Educator courses. In order to assess if the current Practice Educator courses were enabling Practice Educators to achieve the Practice Educator competencies as outlined earlier in this report, a chart was drawn up comparing the content of the courses with these competencies (Please see Appendix 5). On reviewing this chart it is clear to see that the content of the current courses broadly 1 covers the Practice Educator competency areas. The only areas that are not explicitly covered are professionalism and professional practice. None of the Practice Educator courses address these two areas as such areas should be addressed at a different level by therapy line management or by the Professional Bodies. 1 It must be noted that the HEIs were asked to outline the topics they covered in these courses. The means by which they taught the modules or the depth gone into was not reviewed. These were they collated and grouped. This information was then used for this report. 30