Blog by Professor Debra Towse, Senior Expert Advisor to the ADAPT Team, Canterbury Christ Church University and Trustee of the Council of Deans of Health
In the UK, an increasing number of universities act as key constituents for the delivery of contemporary health and social care services, by supporting the development of these workforces. This is achieved in partnership with stakeholder groups, both public service providers and increasingly with those in private, independent, voluntary or industry settings. This partnership working ensures higher education (HE) courses are contemporary, informed by evidence, meet employer expectations and Professional, Statutory, and Regulatory Body (PSRB) standards.
Typically, universities who provide access to this subject area develop a breadth of portfolio to support career long learning for individuals, enabling them to develop the professional skills, knowledge and behaviours required to deliver high quality, safe and appropriate care to the public. Ensuring health and social care students (both pre-registration and post-registration) are fit for practice through their education provision, means universities must be vigilant, and engage in at least annual reviews of content, student feedback, and emerging or new evidence to future proof professional training and student outcomes.
Annual reviews are routinely used by many colleagues within the higher education sector to identify differences in student attainment, progression, and award, using underlying data characteristics to explore outcomes. This cycle of activity has recently shifted focus towards the experience of Global Majorities, with support from national resources (e.g: Universities UK (U-UK)), that flag the need for cultural change at multiple levels. U-UK indicate that the key characteristics to promote success in cultural change for Global Majorities within HE are:
- Strong leadership
- Conversation about culture
- Creating inclusive environments
- Analysis and evidence
- Using what works
It is reasonable to suggest that these five steps are transferable for any cultural change, and there is evidence that focusing on promoting inclusion for a specific group, has benefits for all marginalised sectors of the population.
Recent cultural change in HE
So, let’s reflect on our own contemporary cultural change – the experience of health and social care academics during the last 18 months, throughout the Covid 19 pandemic. This has provided many challenges for our organisations working practices, and curriculum delivery. Although opportunities for conversation may have been limited during crisis management perhaps, most leaders I have worked with have spoken about the recognition of the need to promote equity across the staff and student body in relation to working remotely, and the vital nature of using evidence to inform working practices as it emerged. We have all been part of a cultural and paradigm shift… fuelled by technology…
This period also offered many opportunities, but one of the most significant being widespread rapidly accelerated individual digital/technological competence to facilitate continued access and support (for students, colleagues, and family). Feedback from colleagues indicated that for the vast majority, this has revolutionised their ways of working. Sharing personal experience has promoted technical competence across teams, has increased efficiency (with tips on how to use software to its best advantage) has given ‘permission’ for greater access to colleagues and students (through technologically supported face-to-face contact) which has reduced the reliance on email and reduced carbon footprints. Moving forward, much of this learning continues to inform curriculum delivery plans, particularly the new digital/technological competencies to assist in a more balanced work and home life.
Drawing laterally on this experience, health care improvements have increased survival rates and many individuals are now surviving longer. Some are living with long term conditions, or degenerative diseases which if inadequately managed result in a loss of autonomy, and social exclusion. However, similarly to our experience, there is a revolution and acceleration of Assistive Technology which is supporting the autonomy of individuals in these difficult and potentially isolating situations, to sustain relationships with society.
But is this revolution reflected within our key contribution to the development of the future workforce? Why is this important, and which professions should be involved?
The Assistive Devices for Empowering Disabled People Through Robotic Technologies (ADAPT) Project, gathers partners from France and England, to develop innovative solutions to improve the care, wellbeing, and independence of people with severe disabilities. The third of the four workstreams explores the education aspects of Assistive Technology (AT). An initial literature review of how professionals currently learn about AT established that ‘Most learn their trade by apprenticing, online courses, workshops, email-based discussion groups, consulting with colleagues, and studying manuals, books and tutorials’ and identified the common difficulties and challenges encountered by health and social care professionals as:
Access to Training
- The continued rapid pace of change of Assistive Technology
- The lack of clear definition of AT
- The breadth of environments using AT
- Inadequate marketing to allow training opportunities to be ‘surfaced’
Quality of Training
- An absence of consistent high-quality training
- Training focuses on familiarisation only, with limited ‘applied/hands on training’.
- Training which occurs in isolation, and without collaboration with families and care providers
- Limited professional time
- Retention of expert educators
The review evidenced a gap in professional knowledge around Assistive Technology, recommending this was particularly pertinent for:
- Those currently providing healthcare in practice – registered, unregistered and informal care providers and users (to ensure high quality care for those who use assistive technology).
- Those being prepared for future practice, (to assure future fitness to practice, relating to assistive technology).
Furthermore, whilst the domain of Assistive Technology (AT) generally falls within the remit of those professions involved in Rehabilitative Practice (in terms of needs assessment, customisation, and systematic instruction), for AT use to be sustained transdisciplinary collaboration between acute and community providers, the intended user (and family) is required. Previous studies have identified that in terms of ensuring health practitioners are fit for the future as AT usage increases, they should be more aware of the multiple benefits and untapped potential of AT and be confident of the benefits of AT. The competent and confident practitioner can then act as a ‘champion’, promoting AT to their service users and using the data that Assistive Technologies generate in their practice. This makes a case for a particular type of education experience and supports a view that a wider group of healthcare professionals should be involved since they require:
- An understanding of how Assistive Technology already in place, can be accommodated within a care setting to maximise recovery.
- An increased awareness of what Assistive Technology solutions can offer, to enable timely referrals to expert therapists.
The imperative for ensuring that the current and future workforce are educated to provide appropriate care against the ‘ever-changing population needs’ requires ongoing updating of the current curriculums, for healthcare professions at both pre-registration and post-registration levels. In relation to AT, there is also the requirement for education to encompass those who are users of AT, and their supporters. However, many of us recognise that healthcare professional curriculums are already crowded, and currently PSRB standards are broad and inexplicit on the need to deliver care in partnership specifically for those receiving AT. It is therefore in the remit of individual course teams to surface this as a priority item within the curriculum, reflecting the first element of cultural change – leadership.
The next facet is prompting conversations to create an environment to enable change. To support this, the ADAPT Team has developed a series of FREE readily available online resources, which can create opportunities to explore and develop understanding of AT. They promote reflection and seek to apply learning, as a student or as a professional. The resource can be used to underpin scenarios with users of AT, bringing together different professional participants in care, and their unique perspectives. The resources surface the difficulties faced by practitioners who work to promote social inclusion for this and other groups and provide insights into how technology enables autonomy. The ADAPT Team draw on their ‘real life’ case study of the development of the electric powered wheelchair to demonstrate how users, practitioners, industry, and universities can support innovation.
To ensure clarity on ‘what works’, the free resources have been trialled by family care givers, qualified professionals, and health and social care professional students. Concurrently, the impact on the students learning journey and skills development is being evaluated (which is positive to date). However, there remains much to do – since PSRB standards are not explicit in relation to AT, we – the academic community – can influence this by highlighting the deficit and we can choose to become champions for AT within our own curriculum offerings using the FREE online resource as an adjunct too, or as a focus for interprofessional explorations, which promote autonomy, inclusion, and equity in high quality healthcare experiences for all.
So the questions is… will you ADAPT to future proof your profession?…
Further information can be found on the CCCU ADAPT web pages