Developing occupational therapists' capabilities for decision-making capacity assessments: how does a support role facilitate workplace learning?

INTRODUCTION: Healthcare practitioners are required to develop capabilities in an effective and efficient manner. Yet, developing capabilities in healthcare settings can be challenging due to the unpredictable nature of practice and increasing workloads. Unsurprisingly, healthcare practitioner development is often situated outside of practice, for example in formal teaching sessions. Supporting practitioners to develop capabilities through engagement with day-to-day practice, whilst advantageous in terms of authenticity and being highly valued, remains a key challenge for healthcare educators. This qualitative interview study aimed to explain, from the learner's perspective, how a dedicated support role develops occupational therapists' capability to contribute to decision-making capacity assessments. METHODS: Individual semi-structured interviews were conducted with a purposive sample of 12 occupational therapists. Informed by workplace learning theory, interview transcripts were analyzed using thematic analysis process. RESULTS: Participants provided rich descriptions of how they developed in their capability to engage in decision-making capacity assessments. Participants reported that their learning was facilitated by the dedicated support role in three key ways: 1) structuring a journey of learning, 2) providing tailored guidance, and 3) fostering a supportive learning environment. DISCUSSION: Participants valued the authentic workplace learning opportunities afforded by the dedicated support role. Findings suggest that capabilities, such as decision-making capacity assessment, can be developed through practice when enriched by a dedicated support role. However, further research examining the sustainability and transferability of this model and its application to other capabilities are warranted.

Evaluation of the research capacity and culture of allied health professionals in a large regional public health service.

PURPOSE: The first aim of this study was to evaluate the current research capacity and culture among allied health professionals (AHPs) working in a large regional health service. The second aim of this study was to undertake principal component analyses (PCAs) to determine key components influencing our research capacity and culture. PATIENTS AND METHODS: As part of a cross-sectional observational study, the Research Capacity and Culture (RCC) tool was administered to AHPs working in Gold Coast Health to measure self-reported research capacity and culture across Organization, Team, and Individual domains, including barriers to and motivators for performing research. An exploratory PCA was performed to identify key components influencing research capacity and culture in each of the three domains, and the results were compared with the findings of a previous study performed in a large metropolitan health district. RESULTS: This study found moderate levels of research capacity and culture across all domains, with higher scores (median, IQR) reported for the Organization domain (7,5-8) compared to the Team (6,3-8) and Individual domains (5,2-7). Two components were identified in each domain. Components in the Organization domain included "research culture" and "research infrastructure"; components in the Team domain included "valuing and sharing research" and "supporting research"; and components in the Individual domain included "skills for conducting research" and "skills for searching and critiquing the literature". These components were found to be highly correlated with each other, with correlations between components within each domain ranging from 0.459 to 0.702. CONCLUSION: The results of this study reinforce the need for an integrated "whole of system" approach to research capacity building. Ongoing investment in tailored support and infrastructure is required to maintain current areas of strengths and build on identified areas of weakness at the level of organizations, teams, and individual AHPs, and consideration should also be given as to how support across these three levels is integrated.

Research capacity building frameworks for allied health professionals - a systematic review.

BACKGROUND: Building the capacity of allied health professionals to engage in research has been recognised as a priority due to the many benefits it brings for patients, healthcare professionals, healthcare organisations and society more broadly. There is increasing recognition of the need for a coordinated multi-strategy approach to building research capacity. The aim of this systematic review was to identify existing integrated models and frameworks which guide research capacity building for allied health professionals working in publicly funded secondary and tertiary healthcare organisations. METHODS: A systematic review was undertaken searching five databases (Medline, CINAHL, Embase, AustHealth and Web of Science) using English language restrictions. Two authors independently screened and reviewed studies, extracted data and performed quality assessments using the Mixed Methods Appraisal Tool. Content and thematic analysis methods were used to code and categorise the data. RESULTS: A total of 8492 unique records were screened by title and abstract, of which 20 were reviewed in full-text. One quantitative study and five qualitative studies were included, each of which describing a research capacity building framework. Three interconnected and interdependent themes were identified as being essential for research capacity building, including 'supporting clinicians in research', 'working together' and 'valuing research for excellence'. CONCLUSIONS: The findings of this systematic review have been synthesised to develop a succinct and integrated framework for research capacity building which is relevant for allied health professionals working in publicly funded secondary and tertiary healthcare organisations. This framework provides further evidence to suggest that research capacity building strategies are interlinked and interdependent and should be implemented as part of an integrated 'whole of system' approach, with commitment and support from all levels of leadership and management. Future directions for research include using behaviour change and knowledge translation theories to guide the implementation and evaluation of this new framework. TRIAL REGISTRATION: The protocol for this systematic review has been registered with PROSPERO. The registration number is CRD42018087476 .