Focus On Clinical Educator’s Competence Profile - A Field Research In Interprofessional And Cross-sectorial Approaches For Health Education

Author(s):

Tina Kramer(presenting / submitting)

Conference:

ECER 2015

Network:

Emerging Researchers' Group (for presentation at Emerging Researchers' Conference)

Format:

Paper

Session Information

ERG SES C 10, Health and Education

Paper Session

Time:

2015-09-07

11:00-12:30

Room:

334. [Main]

Chair:

Theo Wubbels

Contribution

The Danish healthcare system is challenged by a differentiation between professions, units and sectors (1, 2), while increased coherence in patient pathways is a central requirement (3, 4). The challenges for the health care system are expressed when professionals point out deficiencies in the collaboration (5), and the patients expresses their insecurity, whether they get the right treatment (6-10). According to this, the challenges are about sharing knowledge, but also about inadequate cooperation across sectors, departments and units (11-14). Establishing coherent patient pathways is a necessary goal and coordination and collaboration between professions, units and sectors, is thus necessary. The development requires new knowledge on several organisational levels (15). Mono professional basic assumptions continue to challenge the collaboration among health professionals (14). Creating of coherence is based on the professional’s knowledge about each others tasks, competences and working conditions, and based on involvement of the patient’s resources and expressed wishes (16, 17).

The World Health Organisation documents that interprofessional collaboration contributes to improve the treatment of the patient (18). Current rapports indicate, that the strengthening of interprofessional collaboration in education and practice contributes to improve coherent patient pathway (19-21). The fact that reports can point out trends, but also on requirements and obstacles, sharpens the need for empirical studies and analyses of interporfessional and health care practice. According to KORA[1] there is a lack of empirical knowledge and theoretical frameworks, in terms of cross-sectorial collaboration. It is predominantly “cookbook instructions” that characterizes the field, and not knowledge about how the collaboration is handled (22).

This Industrial PhD Project’s starting point is both the current trends, and the specific development work, such as the concept InterTvaers, which is an ongoing collaboration project between Aarhus University Hospital, Municipality of Aarhus, Aarhus University and VIA University College, Faculty of Health Sciences. The purpose of InterTvaers, is to strengthen the coherence of patient pathway by strengthen the interprofessional skills of students in health education.

As a result of the projects preliminary experience, InterTvaers reports (23, 24) are pointing out, that despite the clinical educator’s central roles in the field, their competencies remain undescribed and undefined. The clinical educators is expected to act as role models, culture bearers, supervisors, and teachers, and thereby guide the students, while the joint activities refers to areas of knowledge and competencies that the health professionals and the organisation have not yet mastered. InterTvaes is as well as the organisation in general, depending on clinical educators abilities to supervise interprofessional and cross-sectorial.

Therefore the continuous accumulation of experience, internal evaluation and in the future more systematic exploration of the clinical educator’s competencies, and competence profile, required.

InterTvaers is developing study models and teaching concepts, where students in health educations develop competencies in interprofesssional and cross-sectorial collaboration.

Pilot projects has been conducted, where teams consisting of students in the end of their education from the physiotherapy, occupational therapy, nursing bachelor degree programme and a medical student, underwent clinical education and together focused on a patient pathway during hospitalisation. After discharge they followed the patient in their own home joining the primary care services in the municipality. This Industrial PhD Project focuses on InterTværs as an interprofessional course, and brings empirical focus on the course’s competency. How do clinical educators supervise students in the InterTvaers project?

How do clinical educators plan and carry out the supervising course in InterTvaers?
How does the clinical educators competence profile appears?
What significance has clinical educator’s competence profile for the organisation?
How does the organisation develop and where does the Danish Healthcare System evolve to?

[1] Nationale Institut www.kora.dk

Method

This Industrial PhD project's methodological approach is described as ethnographic methodical multiples and 'multi-site etnography' Marcus 1995, Borgnakke 1996, Hammersley and Atkinson 2007 (25-28). The research project practice orientation is emphasized as the professional practice is studied, in the health care field and in real learning contexts, where InterTvaers and clinical educators participate. Progress, frameworks and practices for clinical educator’s competencies will be mapped and explored at the organisational and managerial level, at the planning level and at the specific level of supervising. The survey aims to provide an overview of InterTvaers as an interprofessional process, identify the milestones, distinctive competencies and supervising activities. The empirical phase is scheduled from Marts 2015 to May 2016. The first empirical studies will be conducted by one month of intensive field studies in Marts 2015. When mapping the field is an empirical goal, multiple methods are necessary (29). Planning: • Gathering document analysis and characterisation of the interprofessionel process in InterTvaers, including interviews with key persons at management level. • Intensive field studies with participant observation and videos of clinical educators meetings, interprofessional conferences and mono- and interprofessional supervising situations. • Interviews with clinical educators, before and after participating in InterTvaers. • Clinical educator’s video diary. This project is moving on several levels; on the health and education policy macro-level, the institutional meso-level and the micro-level where supervising takes place. These movements between different levels of importance influence the theoretical approaches, correspondingly moves between the concepts of the professional communities of practice, mono- and interprofessionalism and concepts attached directly to the supervising situation and learning potential.

Expected Outcomes

The Industrial PhD project aims to explore and describe clinical educator’s competence profile. In that respect the project will strengthen the innovative development and a sharpened profile for clinical educator’s interprofessional and cross-sectorial competence profile. The significant contribution of the project, with specific knowledge about activities, strengthens organisational learning in relation to the ongoing development projects and in relation to the future development strategies. The PhD project’s aim is to generate knowledge of: • The clinical educators (inter) professional competencies and competence profile, which the future development of the health care system can rely on. • Organisational development of an interprofessional and inter- sectorial perspective • The interaction between clinical educators competence development and organisational learning The Industrial PhD project is based on the ongoing InterTvaers and the already gathered experiences (23, 24). The gathering of experiences is based on logbooks from students and interviews, with both students and clinical educators. The already gathered experiences (23, 24) suggest three particularly sensitive areas: • The organisational perspective where planning and coordination of the course of InterTvaers is a logistic challenge, similarly to the challenges in the patient’s pathway. • The economic perspective with resource-intensive demands, with a clinical educator from each on of the involved educations. • The didactic perspective concerning lack of methods of teaching, supervising and learning to support learning interprofessional collaboration and the developing of shared goals.

References

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Author Information

Tina Kramer (presenting / submitting)

Aarhus University Hospital

Viby J

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