Stiofán Mac Suibhne

10:00 Focus Questions10:20 Feed Back & Regulatory Context11:30 Morning Tea11:50 Assessment MethodologyLearning Needs Analysis1:00 Working Lunch 1:45 LNA Clinical & Regulatory Exercise3:30 Afternoon TeaAssessment ToolsFinish 5 PM

What is competence?

How should we assess competency?

What is a competent authority pathway (CAP)?

Why do we need CAP?

Potential Applications of ePortfolio

Evaluating work based learning

A Simple Model of Competence

Miller GE. The assessment of clinical skills/competence/performance.

Academic Medicine (Supplement) 1990; 65: S63-S7.

Knows

Shows how

Knows how

Does

Pro

fess

iona

l aut

hent

icity

Written, Oral orComputer based assessment

Performance or hands on assessment

Miller’sPyramid

Patient Outcomes

Changes in Professional

Practice

What Knowledge Skills & Attitudes have they acquired as a result?

How did the learners react to the work -based learning experience?

Evaluating work based learning

(1) The principal purpose of this Act is to protect the health and safety of members of the public by providing for mechanisms to ensure that health practitioners are competent and fit to practise their professions.

Timeline

Reflective Practitioner Model

Assessment / Learning - Portfolio

e-Portfolio PebblePad

Professional Development - Competence Programme / Recertification Programme Section 40 / 41

OCNZ Scope of Practice Reform 2007 - 12 UTS Osteopathic Capabilities Framework 2007-09 OCNZ / ANZOC Development of work-based

competence assessment 2010 - 2012 OCNZ Preceptor Training 2012 Unitec – Clinical Practicum 2013 Trialled for overseas assessment 2013 WMA Grandfathering process Aug 2014 Peer Group Training August 2014 Overseas Assessment Process from Jan 2015 Preceptors using for personal CPD 2015 Recertification Mandatory 2016/17

Reflective practice: ‘the capacity to reflect on action so as to engage in a process of continuous learning’ (Donald Schön 1930 –1997).

Schön felt this was one of the defining characteristics of professional practice.

Educationalist interested in the processes by which professionals develop their knowledge base and apply it to practice.

prac·ti·tion·er / prakˈtiSHənər/

Noun:

A person actively engaged in a discipline, or profession, esp. medicine.

prac·tice / ˈpraktəs/ Noun:The actual application or use of an idea, belief, or method as opposed to theories about such application or use.

prac·tise / ˈpraktəs/ Verb:Perform (an activity) or exercise (a skill) repeatedly or regularly in order to improve or maintain one's proficiency.

The critically reflective practitioner is one that is able to draw on the experience of his or her daily practice as a source of learning.

This approach to practice is empowering the individual, as it is the individual practitioner in the context of their practice that is the reference point for learning, not expert opinion, the contents of journals or compliance with regulatory requirements.

Progress not perfection

A weakness in the evidence-based practice is the assumption that knowledge of itself will change practice.

Motivation, limited time and information resources available to clinicians in reality is a barrier to evidence informing practice.

In the absence of reflection it is likely that ‘evidence’ remains apart from practice.

Reflective practice did not emerge from a single professional discipline, it is effectively a synthesis of knowledge and experience from a variety of academic approaches with the aim of understanding professional practice and improving the quality of learning in professional life.

Widely adopted as an approach to training and developing meaningful assessment methods in the ‘helping professions’.

Conventional wisdom of Evidence based practice applies theoretical knowledge to practice.

In reflective practice theory and practice are seen as being reciprocally inter-related.

Professional identity / knowledge is complex and is not merely assembled from discreet knowledge base.

Professional knowledge / identity arises from a synthesis of natural and social sciences

Model 1 -Technist: is based in scientific knowledge traditions. Practice is seen as an array of “techniques that can be changed, improved or learned independently of the ‘contingent and temporal circumstances’ in which practices are embedded.

To achieve this, such knowledge must by definition eliminate the inherent complexity of the everyday thinking that actually occurs in practice.

‘Technical Rationality is the Positivist epistemology of practice…….Institutionalized in the modern university, founded in the late C19th when Positivism was at its height, and the professional schools which secured their place in the university in the early decades of the C20th ‘

Schön (1983) p 14 in: Critically Reflective Practitioner. Thompson. Palgrave MacMillan. London (2008).

‘We can see that, if followed rigidly, the technical rationality model reduces practitioners to the level of technicians whose only role is to implement the research findings and theoretical models of the scientists, researchers and theoreticians‘

Rolfe et al (2001) p 15 in: Critically Reflective Practitioner. Thompson. Palgrave MacMillan. London (2008).

Model 2 - Broader Model of Practice: draws from practical knowledge traditions. Practices are fluid, changeable and dynamic, characterised by their ‘alterability, indeterminacy and particularity’.

In this model, knowledge must be a flexible concept, capable of attending to the important features of specific situations. Practice is understood as ‘situated action’.

Kemmis, S. (2005) “Knowing Practice :searching for saliencies.” Pedagogy, Culture and Society, Volume 13, Number 3Schwandt, T.A. (2005) “The Centrality of Practice to Evaluation” American Journal of Evaluation 26: 95

Reflection-in-Action: as we work identifying learning needs / opportunities

Reflection-on-Action: After the fact seeking theoretical perspectives and integrating them into our thinking

Reflection-for Action: Applying knowledge to practice

Creating Personal reflective space / Organisational Context. Thinking>Analysis>Self>Awareness

Skills acquisition: Cognitive - Associative - Autonomous - "OK" Plateau - Fitts & Posner.

Freshen-up - you need to maintain interest in your practise

Honesty & Openness to change / development

FaçadeKnown to

Self

Arena Known to

All

UnknownKnown to

no one

Blind Spot Known to

Others

- Known to Others +

+ K

now

n to

Self -

Johari Window

What are my roles and duties? What are my goals? How will I achieve them? What are my priorities? What strategies are available to me? Who can I rely on to support me? What previous learning can I draw upon to

help me cope with current challenges?

Where am I now? Where am I now in my professional life and what have I already

achieved? What are my strengths and what areas do I need to develop

further? What challenges in my professional work as an osteopath have I

found difficult and not fully addressed? What development of my knowledge and skills would enhance my

practise as an osteopath for the benefit of my patients? What learning activities are ongoing and what progress has been

made? What previous CPD learning needs are to be reinforced or

advanced?

Where do I want to be? Consider your aims and objectives for the future: What areas of interest would I like to pursue further? What aspirations do I have for my career and what direction

should I take? What areas of learning are vital for my career progression?

How do I get there?Personal Development Plan

How do I know I have got there?Evidence

InterprofessionalRelationships

Primary Healthcare

Responsibilities

Osteopathic Care &Scope of

Practice

Person Orientated Care & Commuication

Professional & Business Activities

Clinical Analysis

An understanding of the nature of ‘Practice’ is central to designing an assessment process which is capable of capturing evidence of an individual’s ability to practice.

The first step in designing the assessment process was accepting a conceptual model for osteopathic practice.

Then developing an analysis / deconstruction of practice from the perspective of process - rather focussed on academic knowledge – Osteopathic Capabilities Framework.

Identifying assessment tools to assess the various components of practice. K S A

Miller’s pyramid of competence indicates that assessment of ‘does’ reflects professional authenticity.

Whatever one ‘does’ in the assessment must reflect practice in order for that assessment to be authentic.

The portfolio purpose is to guide learning and capture evidence

Portfolio was the Hoorah word of ‘90s

Evidenced Based Practice ’oos

e-Portfolio is current Hoorah!

Trial the e-Portfolio for the overseas assessment processes

Reference Group to look at applications for CPD / Revalidation Processes

InterprofessionalRelationships

Primary Healthcare

Responsibilities

Osteopathic Care &Scope of

Practice

Person Orientated Care & Commuication

Professional & Business Activities

Clinical Analysis

Pedagogy – Teacher determines content / deliver / learning goals and assessment

Andragogy – Self Directed Learning

Adult education and characterised by learner control and self-responsibility in learning, learner definition of learning objectives in relation to their relevance to the learner, a problem-solving approach to learning, self-directedness in how to learn, intrinsic learner motivation, and incorporation of the learner experience

Heutagogy (based on the Greek for “self”) was defined by Hase and Kenyon in 2000 as the study of self-determined learning.

Heutagogy applies a holistic approach to developing learner capabilities, with learning as an active and proactive process, and learners serving as “the major agent in their own learning, which occurs as a result of personal experiences”

Learning Needs Analysis

Personal Development Plan

Evidence

Case based Discussion

Critical Incident Report

Critiquing journal articles

Literature reviews

Reflective statement from training courses

Osteopathic Exceptionalism & Magical

Low IT skills – take responsibility

Regulatory Refuseniks & oppositional reflex

People feel safe with paper

Assessment anxiety – recovery from educational abuse