Exploring the factors that affect the transition from student to health professional: an Integrative review.

BACKGROUND: The nature of a new health professional's transition from student to health professional is a significant determinant of the ease or difficulty of the journey to professional competence. The integrative review will explore the extent of literature on the factors that impact the transition of new health professionals into practice, identify possible gaps and synthesise findings which will inform further research. The aim was to identify research conducted in the last two decades on the barriers, facilitators and coping strategies employed by new health professionals during their transition into practice. METHODS: Whittemore and Knafl's methodological framework for conducting integrative reviews was used to guide this review. Sources between 1999 and 2019 were gathered using EBSCOhost (including CINAHL, Medline, Academic Search Premier, Health Science: Nursing and Academic Edition), PubMed, Scopus, Cochrane and Web of Science, as well as hand searching and follow-up of bibliographies followed. The Covidence platform was used to manage the project. All studies were screened against a predetermined selection criteria. Relevant data was extracted from included sources and analysed using thematic analysis approach. RESULTS: Of the 562 studies identified, relevant data was extracted from 24 studies that met the inclusion criteria, and analysed to form this review. Thematic analysis approach was used to categorise the findings into theme areas. Four overarching themes emerged namely: systems and structures, personal capacities, professional competence and mediating processes. Each theme revealed the barriers, facilitators and coping strategies of transition into practice among new health graduates. CONCLUSION: The transition into practice for new health practitioners has been described as complex and a period of great stress. Increasing clinical and practical experiences during education are required to support new health professionals in the process of closing the gap between learning and practice. Continued professional development activities should be readily available and attendance of these encouraged.

Views of Service Users, Their Family or Carers, and Health Care Professionals on Telerehabilitation for People With Neurological Conditions in Ghana: Qualitative Study.

BACKGROUND: Up to 50% of people in low- and middle-income countries do not receive the rehabilitation they require. Telerehabilitation has the potential to improve access to neurorehabilitation services especially in low- and middle-income countries. Although there are reports of the barriers and facilitators to telerehabilitation in such settings, almost all are anecdotal. Furthermore, family or carers have a significant influence on the adoption and success of telerehabilitation, but their views have not been reported. OBJECTIVE: This study aimed to investigate the views of service users, their family or carers, and health care professionals (HCPs) on telerehabilitation for people with neurological conditions in Ghana. METHODS: Two focus groups were held at Komfo Anokye Hospital in Kumasi, Ghana: one in person for service users (n=11) and their family or carers (n=9), conducted in the Ghanaian language of Twi, and one hybrid for HCPs (n=18) conducted in English. The mean (SD) age of the service users was 59.8 (8.6) years; 5 users had a stroke and 6 had Parkinson disease. The HCP group consisted of 7 speech and language therapists, 3 physiotherapists, 3 occupational therapists, 3 medical staff, 1 nurse, and 1 industry representative. Focus groups were semi-structured and explored previous experiences of telerehabilitation, perceived benefits and challenges, and solutions to overcome these challenges. Focus groups were audio transcribed, and the service user transcript was translated into English. The resulting transcripts were analyzed using thematic analysis. RESULTS: Overall, participants were positive about the role of telerehabilitation but recommended hybrid delivery, with in-person rehabilitation in the early stages and telerehabilitation in the later stages. In relation to telerehabilitation in Ghana, there were 3 main themes: benefits, challenges or barriers, and implementation. Benefits included the convenience and lower cost for service users, the higher dose of therapy possible, and increased access for people in remote areas. However, challenges included lack of a stable internet connection, cost of phones and data packages, and low levels of literacy. Implementation issues included cultural relevance, information governance, and the platform used to deliver telerehabilitation, with most participants being familiar with WhatsApp. CONCLUSIONS: Telerehabilitation has the potential to be a useful method of delivering rehabilitation to people with neurological conditions in Ghana, especially in a hybrid rehabilitation model with telerehabilitation augmenting in-person sessions. However, many people were unaware of telerehabilitation, and challenges such as a reliable internet connection, cultural relevance, and costs need to be addressed. Clinical trials of low-cost telerehabilitation interventions contextualized to the specific user group are required.

Exploring the transition from student to health professional by the first cohort of locally trained occupational therapists in Ghana.

INTRODUCTION: The transition from student to occupational therapist for new graduates has been described as a period of extreme stress and anxiety; novice therapists enter a world that is new and complex upon starting clinical practice. The first locally-trained occupational therapists in Ghana worked autonomously and in a self-directed manner from their first year of practice in a country where occupational therapy had not been established. The study sought to explore the transition from student to clinician, made by the first cohort of locally trained occupational therapists in Ghana. METHODS: An interpretive phenomenology approach was used to explore participants' experiences of their transition from occupational therapy students to clinicians in Ghana. Six participants were selected using purposive, maximum variation, sampling. Data were collected by means of in-depth interviews and analysed using an iterative, inductive approach. RESULTS: Four themes emerged: Being 'new' in a new profession, introducing occupational therapy into a new environment, Personal and professional competence, and 'The future is bright'. New graduates found continued professional development activities, such as additional reading, seminars and conferences, essential for successful transition into practice. CONCLUSION: The importance of supervision and mentorship was highlighted in the study. Explicit attention to factors that support assimilation of new graduates within health care facilities were highlighted. The importance of continued professional development in development of practice competencies was foregrounded. Strategies to facilitate multi-professional work were demonstrated.

Exploring the factors that affect new graduates' transition from students to health professionals: a systematic integrative review protocol.

INTRODUCTION: To become a competent health professional, the nature of new graduates' transition plays a fundamental role. The systematic integrative review will aim to identify the existing literature pertaining to the barriers during transition, the facilitators and the evidence-based coping strategies that assist new graduate health professionals to successfully transition from students to health professionals. METHODS AND ANALYSIS: The integrative review will be conducted using Whittemore and Knafl's integrative review methodology. Boolean search terms have been developed in consultation with an experienced librarian, using Medical Subject Heading terms on Medline. The following electronic databases have been chosen to ensure that all relevant literature are captured for this review: PubMed, EBSCOhost (including Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline, Academic Search Premier, Health Science: Nursing and Academic Edition), Scopus and Web of Science. A follow-up on the reference list of selected articles will be done to ensure that all relevant literature is included. The Covidence platform will be used to facilitate the process. ETHICS AND DISSEMINATION: Ethical approval is not required for this integrative review since the existing literature will be synthesised. The integrative review will be published in a peer-reviewed journal once all the steps have been completed. The findings will also be presented at international and national conferences to ensure maximum dissemination.