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J Health Organ Manag ; 31(2): 709-724, 2020 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-32979045


PURPOSE: Highly-experienced allied health professionals have the opportunity to perform at the expert-level by sharing knowledge and skills with more junior staff, with the aim of upskilling the workforce. The study explored the current motivators, aspirations and the role of work in the life of highly-experienced practitioners, revealing factors that hinder or support them to further develop their own expertise and be inspiring role-models and mentors for less experienced staff. DESIGN/METHODOLOGY/APPROACH: Taking a grounded theoretical research design, we report on interviews with 45 allied health practitioners with at least seven years of professional experience from different professions and across organisational sectors. Transcripts were coded iteratively in conjunction with reviewing the literature, and cases were categorised to form a conceptual typology of work orientation. FINDINGS: Four work orientations are characterised capturing the diversity of the allied health workforce, particularly in relation to two dimensions of personal fulfilment and future ambition. The relationship between the types and expert-level performance is discussed, leading to recommendations for support that can be implemented to develop and sustain expert-level performance within a community. ORIGINALITY/VALUE: A new view of work orientation is introduced that relates expert-level performance with meaningful work. The findings highlight a diversity of work orientation for highly-experienced allied health professionals, that all require managerial awareness. Once recognised, the four types would benefit from different supports that could develop and maintain expert-level performance in those that seek it. Alternatives are also available for those that do not. Implications for workforce policy are discussed.

Pessoal Técnico de Saúde , Competência Clínica , Satisfação no Emprego , Adulto , Idoso , Pessoal Técnico de Saúde/psicologia , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Nova Zelândia , Pesquisa Qualitativa , Adulto Jovem
J Allied Health ; 48(3): 226-232, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31487363


BACKGROUND: Although experienced and expert practitioners are valuable resources for the continuing professional development of other healthcare staff, there is not always a desire to take on this role. Sharing expertise benefits other practitioners, the profession, and healthcare overall. When professionals are unwilling to share, it is a missed opportunity to achieve the best outcomes for patients. METHODS: A narrative review of the literature in relation to professional confidence and expertise across allied health disciplines revealed a number of potential threats to professional confidence and consequently willingness to share information in an 'expert' role. FINDINGS: There is limited literature addressing development of professional confidence post-qualification, particularly after the first year of practice. Role ambiguity, unclear scope of practice, low professional status, and role conflict all threaten the confidence of practitioners. The importance of reflection as a practice to develop and maintain confidence is highlighted in both the student and practitioner literature. CONCLUSION: Training organisations and health workforce employers should consider how professional confidence can be developed and maintained across the career span, with subsequent benefits for development of expertise and knowledge sharing. Recommendations for reflexive thinking and conversations are included.

Pessoal Técnico de Saúde , Competência Clínica/normas , Autoeficácia , Pessoal Técnico de Saúde/educação , Humanos
J Health Organ Manag ; 31(6): 614-629, 2017 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-29034828


Purpose The current healthcare environment provides several challenges to the existing roles of healthcare professionals. The value of the professional expert is also under scrutiny. The purpose of this paper is to generate a construction of professional expertise amongst practitioners in the current healthcare environment. It used the speech-language therapy community in New Zealand (NZ) as an example. Design/methodology/approach Speech-language therapists currently practicing in NZ completed an online survey including qualitative and quantitative components. The range of experience and work settings of participants ( n=119) was representative of the workforce. Findings Participants clearly identified being "highly experienced" and "having in-depth knowledge" as essential elements of professional expertise. Thematic analysis generated two interconnected themes of a professional expert being a personal leader and teacher, and a highly experienced, knowledgeable and skilful practitioner. Additionally, practitioners needed to be seen to contribute to the community in order to be known as experts. Clinical practice was valued differently from research generation. Originality/value This study is novel in exploring a construction of professional expertise amongst practitioners in a current healthcare community. Within that community, experts could be viewed as highly effective practitioners that visibly contribute to the professional community. The study draws attention to the role of reputation and the impacts of being a clinical teacher or leader compared with pursuing a research role. This could be particularly relevant in the promotion of evidence-based practice.

Competência Clínica , Fonoterapia , Adulto , Humanos , Relações Interprofissionais , Pessoa de Meia-Idade , Nova Zelândia , Papel Profissional , Fonoterapia/normas , Inquéritos e Questionários
Acta Paediatr ; 105(1): e1-6, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26408819


AIM: The aim of this study was to determine the factors that predict the timing and age at which preterm infants (born 32-36 weeks gestation) commenced and attained full oral feeding. METHODS: We conducted a retrospective review of medical records of 647 preterm infants born 2005-2011. Infants were from six neonatal intensive care units in New Zealand, all World Health Organisation Baby-friendly Hospital Initiative accredited. RESULTS: Median time to the first oral feed offered was one day, and median time to the time of full oral feeding was 12 days. No infants attained full oral feeding before 33(+3) weeks postmenstrual age. Gestational age, birthweight, medical conditions and location of the neonatal unit were significantly associated with the time taken to commence and attain full oral feeding. CONCLUSION: This study highlights the factors that are associated with the rate at which late preterm infants commence oral feeding and progress to full oral feeding. These findings offer important considerations not only for clinical practice but also discharge planning given the preference for preterm infants reaching full oral feeds before discharge from hospital. Prospective experimental research is required to confirm infant, maternal and environmental factors that influence feeding milestones in late preterm infants.

Alimentação Artificial/estatística & dados numéricos , Aleitamento Materno/estatística & dados numéricos , Nutrição Enteral/métodos , Recém-Nascido Prematuro/fisiologia , Peso ao Nascer , Nutrição Enteral/estatística & dados numéricos , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Masculino , Nova Zelândia , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Tempo