Allied Health Professionals Utilization of Standard Measures: Assessing Measurement Practice in Physical Medicine and Rehabilitation.

Hundreds of standard measures have been developed to assess a diverse array of conditions, characteristics, and outcomes essential to the practice of medical rehabilitation. These measures provide a common metric needed to coordinate care, communicate with stakeholders, and assess treatment efficacy. Allied health professionals typically rely on functional measures that correspond to their discipline and scope of practice, yet functional outcomes may be dependent on psychological and social (psychosocial) factors that affect a client's capacity to engage and actively participate in their care. The purpose of this study was to describe and compare the use of standard measures by allied health professionals, assess attitudes and beliefs regarding the use of these measures, and identify opportunities to enhance the utilization of these measures in regular clinical practice. To these ends, a 144-item survey was developed and administered to a national sample of 92 clinicians (physical and occupational therapy, recreational therapy, speech-language pathology, psychology and social work). Results indicate that a majority of participants reported using both functional and psychosocial measures. The three most assessed domains across disciplines were physical function (74%), activities of daily living (67%), and vital signs (57%), while speech and vocational assessments were measured less frequently. Utilization of psychological and social measures overall ranged from 39% for measures of community participation to 14% for work and economic outcomes. As function often plays a critical role in recovery, opportunities to enhance care may be realized by using a more comprehensive assessment strategy that includes both functional and psychosocial measures.

A Framework for Teaching Development at a Specialized Graduate Institution.

The path for faculty advancement and self-improvement is often uncertain in higher education. Even in the health professions, where we diligently prepare graduate students for clinical roles, our pathways for new faculty transitioning from clinical to teaching roles are often nebulous. This article describes the process that the MGH Institute of Health Professions undertook in developing a set of Faculty Development Domains to guide graduate health professions faculty as they progress through their teaching careers. The aim was to provide faculty with a framework for guidance and self-assessment to identify areas for improvement that align with institutional priorities and that will elevate their teaching and professional roles. This process of developing the framework, which included a review of the literature, iterative revisions, and faculty focus groups, ultimately yielded four comprehensive domains that encompass "good teaching": planning and preparation, classroom environment, instruction, and professional responsibilities.

[SICI-GISE Position paper on the standards of cardiac catheterization laboratories in Italy: qualitative and quantitative standards of the Nurses and Allied Professionals Group]. / Documento di posizione SICI-GISE sugli standard dei laboratori di diagnostica e interventistica cardiovascolare: le professioni sanitarie del comparto standard qualitativi e quantitativi.

This document aims to be an integral part of the SICI-GISE position document on standards and guidelines for cardiovascular diagnostic intervention laboratories published in October 2015. It was created with the aim of defining quality and quantitative standards by providing practical support for the structuring of a training course to reach high levels of assistance for nursing and technical personnel working within the catheterization laboratories. The competences detected are the expression of a highly specialized organizational and operational reality that combines technicality with a well-defined clinical assistance need as an expression of a real patient care. The Nurses & Technicians Area of SICI-GISE aimed at issuing a flexible and dynamic document based on technical and operational progress which, in addition to defining qualitative and quantitative standards, describes the underlying knowledge of the professionals of the sector operating in our laboratories. This is the first experience that, through a survey carried out in 2015, has been able to decline qualitative and quantitative data so as to provide resources and skills for measuring and improving assistance outcomes.

Perspectives from practice: complexities of personal care workers.

Personal care workers (PCWs) make up the bulk of the workforce in residential and community care services. The knowledge and skill set needed for safe and effective practice in care settings is extensive. A diverse range of registered training organisations (RTOs) offering Certificate III and IV in Individual Support (aging, home and community) are tasked with producing job-ready PCWs. However, the curricula of these programs vary. Additionally, a national code of conduct for healthcare workers became effective in October 2015 as a governance framework for PCWs. The language of the code statements is ambiguous making it unclear how this framework should be translated by RTOs and applied in the preservice practice preparation of PCWs. Employers of PCWs need to feel confident that the content of the preservice education of PCWs satisfactorily prepares them for the diverse contexts of their practice. Likewise, the health professionals who supervise PCWs must be assured about the knowledge and skills of the PCW if they are to safely delegate care activities. The perspectives presented in this discussion make it clear that investigation into the nebulous nature of PCW education, regulation and practice is needed to identify the shortcomings and enable improved practice.

Competency standards for newly graduated prosthetist/orthotists in Sweden.

BACKGROUND: There are currently no national competency standards upon which to develop educational objectives for prosthetist/orthotists in Sweden. While standards have been developed in other countries, they cannot be applied without confirming their relevance in a Swedish context. OBJECTIVES: To describe and obtain consensus on core competencies required for newly graduated prosthetist/orthotists in Sweden. STUDY DESIGN: Modified Delphi process. METHODS: A modified Delphi technique was carried out. Focus groups were initially used to identify core competency domains. Two consecutive questionnaires, containing a list of potential competency items, were sent to a group of stakeholders with ties to the prosthetic and orthotic profession. Stakeholders were requested to rate their level of agreement with each competency item and provide written comments. Finally, two focus groups were conducted to obtain feedback on the draft competency standards. RESULTS: Forty-four competency items, listed under five key domains of practice, were identified as essential for newly graduated prosthetist/orthotists in Sweden. CONCLUSIONS: Many similarities exist in core competency descriptions for prosthetist/orthotists in Sweden when compared to other countries. Regional differences do however exist, and it is important to confirm the relevance of core competency items at a national level before they are applied. Clinical relevance Competency standards developed in this study can be used to guide development of learning objectives within an undergraduate prosthetic and orthotic program, provide a framework for workforce development, assist professional organizations in understanding the needs of their members, and prepare for international accreditation.

Best Practices in Bridging Education: Multiple Case Study Evaluation of Postsecondary Bridging Programs for Internationally Educated Health Professionals.

AIMS: Bridging education for internationally trained professionals has grown in popularity, but little is known about promising practices for bridging education in allied health professions. This paper addresses this gap by examining the expected outcomes of effective bridging programs, the key features that contribute to their effectiveness, challenges faced by bridging programs, and the appropriate role of regulatory colleges, government, employers, and professional associations in bridging education. METHODS: We conducted a mixed-methods multiple case study analysis of seven bridging programs in Ontario, Canada, in five allied health professions: medical laboratory technology, medical radiation technology, diagnostic medical sonography, respiratory therapy, and physical therapy. RESULTS: Effective bridging programs are accessible and flexible in content and format. The key challenges include developing curricula tailored to participants' needs, identifying appropriate format for program delivery, obtaining clinical placements for participants, and achieving financial sustainability. Government, professional, and educational stakeholders should play a central role in bridging education planning and delivery. CONCLUSION: The success of a bridging program relies on two key components-program design and infrastructure. Partnerships with government, professional, and educational stakeholders facilitate the development of good bridging programs.

Professionalism Values in Health Science Education: Self- and Peer-Assessment of Faculty, Staff, and Students.

PURPOSE: Professionalism values are critical to developing health science students. Although many educational programs strive to develop professionalism values within students, few include faculty and staff. We evaluated the professional values of our faculty, staff, and students and evaluated the acceptance of this professionalism program. METHODS: Faculty members adopted a 5-item professionalism assessment survey (honesty, teamwork, responsibility, respect, and communication) and performed a 360° peer assessment among our basic/applied science faculty, clinical faculty, and administrative staff. Data were collected for 3 consecutive years (2013-2015). The 37 students were also assessed as part of their inter-professional education (IPE) program. RESULTS: Peer rankings were stable across years from 2013-2015 for faculty and staff. Faculty with expertise in teaching clinical skills rated "teamwork" (higher) and "respect" (lower), differently from our basic/applied science faculty (p<0.001 and p=0.023, respectively). Faculty and staff supported that the 360° assessments were of value for their own professional development. Student assessments revealed improved "verbal communication" and "teamwork" (p=0.003 and 0.02, respectively) after working in IPE groups during the semester. CONCLUSIONS: An annual professionalism assessment program appears to be one important component to developing professional values among faculty, staff, and students in the health sciences.

Barriers and enablers for the development and implementation of allied health clinical practice guidelines in South African primary healthcare settings: a qualitative study.

BACKGROUND: The South African allied health (AH) primary healthcare (PHC) workforce is challenged with the complex rehabilitation needs of escalating patient numbers. The application of evidence-based care using clinical practice guidelines (CPGs) is one way to make efficient and effective use of resources. Although CPGs are common for AH in high-income countries, there is limited understanding of how to do this in low- to middle-income countries. This paper describes barriers and enablers for AH CPG uptake in South African PHC. METHODS: Semi-structured individual interviews were undertaken with 25 South African AH managers, policymakers, clinicians and academics to explore perspectives on CPGs. Interviews were conducted by researcher dyads, one being familiar with South African AH PHC practice and the other with CPG expertise. Rigour and transparency of data collection was ensured. Interview transcripts were analysed by structuring content into codes, categories and themes. Exemplar quotations were extracted to support themes. RESULTS: CPGs were generally perceived to be relevant to assist AH providers to address the challenges of consistently providing evidence-based care in South African PHC settings. CPGs were considered to be tools for managing clinical, social and economic complexities of AH PHC practice, particularly if CPG recommendations were contextusalised. CPG uptake was one way to deal with increasing pressures to make efficient use of scarce financial resources, and to demonstrate professional legitimacy. Themes comprised organisational infrastructures and capacities for CPG uptake, interactions between AH actors and interaction with broader political structures, the nature of AH evidence in CPGs, and effectively implementing CPGs into practice. CONCLUSION: CPGs contextualised to local circumstances offer South African PHC AH services with an efficient vehicle for putting evidence into practice. There are challenges to doing this, related to local barriers such as geography, AH training, workforce availability, scarce resources, an escalating number of patients requiring complex rehabilitation, and local knowledge. Concerted attempts to implement locally relevant CPGs for AH primary care in South Africa are required to improve widespread commitment to evidence-based care, as well as to plan efficient and effective service delivery models.

Absolute clinical skill decay in the medical, nursing and allied health professions: a scoping review protocol.

REVIEW QUESTIONS/OBJECTIVES: The objective of this scoping review is to examine and map absolute clinical skill decay in the medical, nursing and allied health professions and to map the range of approaches used to address decay of clinical skills in these professions.Specifically, the review questions are: which clinical skills, performed by which professional groups, are reported to be most susceptible to absolute clinical skill decay, and what approaches have been reported for addressing absolute clinical skill decay in the medical, nursing and allied health professions?In addressing the review questions, the following sub-questions will also be addressed:It is anticipated that this scoping review will inform further systematic review/s on the topic of addressing clinical skill decay in the medical, nursing and allied health professions, as well as identify gaps in the research knowledge base that will inform further primary research.

Origem e desenvolvimento da Naturologia no Brasil: aspectos conceituais, históricos e políticos / Origin and development of Naturology in Brazil: conceptual, historical and political aspects

O primeiro bacharelado reconhecido pelo MEC de Naturologia completa 20 anos em 2018. A naturologia é uma profissão recente no Brasil, a qual busca entender o ser-humano multidimensionalmente e respeitar a singularidade humana na busca de bem-estar, qualidade de vida e saúde através da relação de interagência e das Práticas Integrativas e Complementares. Este texto aborda um breve histórico das Práticas Integrativas e Complementares e Naturologia no Brasil, o processo de reconhecimento da ocupação e regulamentação da profissão. O texto também explora os campos de atuação do naturólogo, órgãos de representação profissional, principais eventos científicos e publicações importantes da área.(AU)

The first course recognized bu the Ministry of Education of Naturology completes 20 years in 2018. Naturology is a new profession in Brazil, one which seeks to understand the human being in a multi-dimensional way, and respect human singularity in its search for well-being, quality of life and health trough a relationship of interagency and Complementary and Intrgrative Pratices. The present article addresses a brief history of Comlementary and Integrative Pratices and Naturology in Brazil, the process of recognizing the occupation and regulation of the profession. The paper also explores the fields in which the naturologist is active, the bodies of professional representation, the main scientific events and important publications in the field.(AU)

Advancing a new evidence-based professional in health care: job task analysis for health and wellness coaches.

BACKGROUND: The pressing need to manage burgeoning chronic disease has led to the emergence of job roles such as health and wellness coaches (HWCs). As use of this title has increased dramatically, so has the need to ensure consistency, quality and safety for health and wellness coaching (HWC) provided in both practice and research. Clear and uniform role definitions and competencies are required to ensure appropriate scope of practice, to allow best practices to emerge, and to support the implementation of well-designed, large scale studies to accumulate a rigorous evidence base. Since the nascent field is replete with heterogeneity in terms of role delineations and competencies, a collaborative volunteer non-profit organization, the National Consortium for Credentialing Health and Wellness Coaches (NCCHWC), has been built over the past six years to support professionalization of the field. METHODS: In 2014, a professionally led Job Task Analysis (JTA) was conducted with 15 carefully selected subject matter experts (SMEs) with diverse education and professional backgrounds who were practicing HWC in a wide variety of settings. After establishing a thorough list of specific tasks employed during HWC, the expert panel discussed the knowledge and skills necessary to competently perform the tasks. Subsequently, a large validation survey assessed the relative importance and frequency of each identified job task in conducting HWC. RESULTS: The JTA identified 21 job tasks as essential to HWC. In the subsequent validation survey, 4026 practicing health and wellness coaches were invited to rate each of the 21 job tasks in terms of their importance and frequency. A response rate of 25.6 % provided a diverse sample (n = 1031) in terms of background, and represented a wide variety of training programs from academia, industry, the private sector and associations. Per best practices, the subset of practicing HWCs (n = 885) provided importance and frequency ratings to be used to calculate task and domain weights that can serve as a foundation for a NCCHWC national certification examination. CONCLUSIONS: This JTA provides a significant step forward in the building of a clear and consistent definition of HWC that will allow for uniform practice standards and enable more stringent methodology to evaluate this promising approach within evidence-based medicine.

Bonesetter interventions and consequences.

OBJECTIVE: Delaying the treatment of bone and tendon injuries may cause unmanageable complications. Bonesetters continue to cause delays in treatment. The purpose of this study was to analyze the medical outcomes of delay due to bonesetter intervention and factors affecting patient treatment preference. METHODS: Among outpatients treated at our clinic between January 2010-December 2012, bonesetter-intervened patients were included, and patient demographics, clinical outcomes, and possible social factors were retrospectively analyzed. Clinical examinations and radiological screening measurements were used to evaluate outcomes. RESULTS: Of the 162 patients, 97 (59.8%) were male, and mean age was 27.5±9.4 years. Eighty-nine (54.9%) of the patients lived in a rural area, and 108 (66.7%) underwent surgery. Bonesetter preference was dictated primarily by elderly relatives (47.6%) or neighbors (33.3%). Patients with a primary school education and unemployed patients mostly preferred bonesetters (p=0.03 and p<0.01, respectively), the explanation for which was the long treatment period and concern of being disabled (p=0.04). Complication rate among patients who were evaluated at a hospital was 33.9%. CONCLUSION: Despite being medically unreliable and often times harmful, bonesetting is still accepted as an alternative treatment modality among uneducated patient and thus remains an ongoing problem in Turkey. Improvements in average education level and increased dissemination of accurate information via various media and non-governmental organizations will be effective in the correction and prevention of the afore-mentioned complications regarding bonesetter interventions.

A mixed-methods research approach to the review of competency standards for orthotist/prosthetists in Australia.

AIM: The requirement for an allied health workforce is expanding as the global burden of disease increases internationally. To safely meet the demand for an expanded workforce of orthotist/prosthetists in Australia, competency based standards, which are up-to-date and evidence-based, are required. The aims of this study were to determine the minimum level for entry into the orthotic/prosthetic profession; to develop entry level competency standards for the profession; and to validate the developed entry-level competency standards within the profession nationally, using an evidence-based approach. METHODS: A mixed-methods research design was applied, using a three-step sequential exploratory design, where step 1 involved collecting and analyzing qualitative data from two focus groups; step 2 involved exploratory instrument development and testing, developing the draft competency standards; and step 3 involved quantitative data collection and analysis - a Delphi survey. In stage 1 (steps 1 and 2), the two focus groups - an expert and a recent graduate group of Australian orthotist/prosthetists - were led by an experienced facilitator, to identify gaps in the current competency standards and then to outline a key purpose, and work roles and tasks for the profession. The resulting domains and activities of the first draft of the competency standards were synthesized using thematic analysis. In stage 2 (step 3), the draft-competency standards were circulated to a purposive sample of the membership of the Australian Orthotic Prosthetic Association, using three rounds of Delphi survey. A project reference group of orthotist/prosthetists reviewed the results of both stages. RESULTS: In stage 1, the expert (n = 10) and the new graduate (n = 8) groups separately identified work roles and tasks, which formed the initial draft of the competency standards. Further drafts were refined and performance criteria added by the project reference group, resulting in the final draft-competency standards. In stage 2, the final draft-competency standards were circulated to 56 members (n = 44 final round) of the Association, who agreed on the key purpose, 6 domains, 18 activities, and 68 performance criteria of the final competency standards. CONCLUSION: This study outlines a rigorous and evidence-based mixed-methods approach for developing and endorsing professional competency standards, which is representative of the views of the profession of orthotist/prosthetists.

Music therapy career aptitude and generalized self-efficacy in music therapy students.

BACKGROUND: While the Music Therapy Career Aptitude Test (MTCAT) provides a measure of student aptitude, measures of perceived self-efficacy may provide additional information about a students' suitability for a music therapy career. OBJECTIVE: As a first step in determining whether future studies examining combined scores from the MTCAT and the Generalized Self-Efficacy (GSE) scale would be useful to help predict academic success in music therapy, we explored the internal reliability of these two measures in a sample of undergraduate students, and the relationship (concurrent validity) of the measures to one another. METHODS: Eighty undergraduate music therapy students (14 male; 66 female) completed the MTCAT and GSE. To determine internal reliability we conducted tests of normality and calculated Cronbach's Coefficient Alpha for each measure. Pearson correlation coefficients were calculated to ascertain the strength of the relationship between the MTCAT and GSE. RESULTS: MTCAT scores were normally distributed and had high internal consistency (Cronbach's α = 0.706). GSE scores were not normally distributed, but had high internal consistency (Cronbach's α = 0.748). The correlation coefficient analysis revealed that MTCAT and GSE scores were moderately correlated ((r = 0.426, p < 0.0001). CONCLUSION: MTCAT scores can be used to partially determine perceived self-efficacy in undergraduate music therapy students; however, a more complete picture of student suitability for music therapy may be determined by administering the GSE alongside the MTCAT. Future studies are needed to determine whether combined MTCAT and GSE scores can be used to predict student success in an undergraduate music therapy program.