Advanced Credentials Research Articles

Learning While Working:

As the demand for lifelong learning increases, many working adults have turned to online graduate education in order to update their skillsets and pursue advanced credentials. Simultaneously, the volume of data available to educators and scholars interested in online learning continues to rise. This study seeks to extend learning analytics applications typically oriented toward understanding student interaction with course content, instructors, and peers to the program level in order to gain insight into the ways in which adult learners manage their learning progress over multiple courses and multiple semesters. Using optimal matching analysis, we identify four distinct profiles of course enrollment behaviour among 1,801 successful graduates of an online master’s program that differ with respect to course load, semesters off, and graduation speed. We found that profiles differed significantly as a function of age and knowledge background, but not with respect to gender, ethnicity, or previous academic performance. Findings indicate the utility of expanding learning analytics focused on the micro-level of analysis to the macro-level of analysis and the utility of grounding learning analytics applications geared toward adult learners in a lifespan development perspective. Implications for program design and educational interventions are discussed.

Manual Therapy in Preadolescent Children: A Delphi Investigation of Physical Therapists in the United States.

Limited research has investigated the use of manual therapy to treat the preadolescent (0-12years of age) population with musculoskeletal and neurological impairments. The purpose of this study was to identify the following among physical therapists holding advanced credentials in pediatrics, neurodevelopmental treatment, or manual therapy: (1) consensus regarding effective techniques in the preadolescent population, (2) differences in opinion, and (3) perceived decision-making barriers and factors regarding use of manual therapy techniques. Credentialed physical therapists in the United States were recruited for a 3-round Delphi investigation. An electronic survey in Round 1 identified musculoskeletal and neurological impairments and the manual techniques considered effective to treat such conditions, in addition to factors and barriers. Responses were used to create the second round, during which a 4-point Likert scale was used to score each survey item. A third round of scoring established consensus. Descriptive statistics and composite scores were calculated for each manual technique by impairment. Between-group differences were calculated using the Mann-Whitney U test with Bonferroni correction. Consensus was determined for several concepts. First, neuromuscular techniques were considered effective across all impairments, and joint mobilizations (grades I-IV) were believed to be effective to treat joint and muscle and myofascial impairments. Second, visceral manipulation and craniosacral therapy were considered ineffective in treating most impairments. There was lack of consensus and clear differences of opinion regarding the use of grade V mobilizations and dry needling. Significant barriers to use of manual therapy were: lack of knowledge, lack of evidence, and fear of litigation and harming patients. This study is an initial step for developing manual therapy guidelines, research, and educational opportunities regarding manual therapy in pediatric physical therapy.

Redesign of Prior Learning Assessment in an Award-Winning Degree Completion Program

In the 21st century economic landscape, many argue the importance of a college degree, as entry into many occupations now requires advanced credentials. Pursuing a college degree costs time and money, often presenting barriers to those pursuing the dream. Prior learning assessment (PLA) offers a solution to spend less time and money earning a college degree by documenting outside learning. PLA shortens time-to-degree, reduces tuition costs, supports student persistence, and boosts degree completion, particularly for adult learners (non- and post-traditional students) and underserved populations. The purpose of this article was to examine PLA within an award-winning degree completion program primarily serving adult learners in order to improve practice. Aligned with the Council for Adult and Experiential Learning's (CAEL) standards for assessing learning, this article discusses the degree completion program, PLA course and competency portfolio, block credit competency model and block credit competency model and portfolio assessment, program administration, and implications.

Impact of the Pharmacy Practice Model Initiative on Clinical Pharmacy Specialist Practice.

This paper describes the goals of the American Society of Health-System Pharmacists' Pharmacy Practice Model Initiative (PPMI) and its recommendations for health-system pharmacy practice transformation to meet future patient care needs and elevate the role of pharmacists as patient care providers. PPMI envisions a future in which pharmacists have greater responsibility for medication-related outcomes and technicians assume greater responsibility for product-related activities. Although the PPMI recommendations have elevated the level of practice in many settings, they also potentially affect existing clinical pharmacists, in general, and clinical pharmacy specialists, in particular. Moreover, although more consistent patient care can be achieved with an expanded team of pharmacist providers, the role of clinical pharmacy specialists must not be diminished, especially in the care of complex patients and populations. Specialist practitioners with advanced training and credentials must be available to model and train pharmacists in generalist positions, residents, and students. Indeed, specialist practitioners are often the innovators and practice leaders. Negotiation between hospitals and pharmacy schools is needed to ensure a continuing role for academic clinical pharmacists and their contributions as educators and researchers. Lessons can be applied from disciplines such as nursing and medicine, which have developed new models of care involving effective collaboration between generalists and specialists. Several different pharmacy practice models have been described to meet the PPMI goals, based on available personnel and local goals. Studies measuring the impact of these new practice models are needed.

Career opportunities in global health: A snapshot of the current employment landscape.

Career opportunities in global health: A snapshot of the current employment landscape.

Developing a Professional Self-confidence to Last a Lifetime

•This article will be of interest to the new doctor of nursing practice, graduate student, or registered nurse pursuing advanced credentials. Denise Gasalberti, PhD, is an assistant professor at Wagner College in Staten Island, NY, and can be reached at [email protected].

An application of the competency model to group-specialty practice.

Professional psychology has entered a new era of assessing education and training, practice standards and guidelines based on measuring professional competencies using benchmark documents and graphic three-dimensional cubes, which aspire to cover education at all developmental levels—undergraduate through advanced credentialing. Specialties in psychology, such as clinical health, forensic, or clinical child, are developing within this endeavor. Over one hundred years of history, research and practice inform one of those specialties: group. This paper identifies the group-specialty practice within both the competency and specialty movements by delineating competencies unique to group practice, as well as competencies common across all professional psychology foundational and functional domains appropriate for entry-level psychologists.

Lost in the Rush to National Reform: Recommendations to Improve Impact on Behavioral Health Providers in Rural Areas

As the United States embarks on the most ambitious national health reform since the 1960s, this article highlights the challenges faced by behavioral health agencies, providers, and clients in rural areas and presents recommendations to improve access to and quality of services. Lessons learned from five years of research on a major systems-change initiative in New Mexico illuminate potential problem areas for rural agencies under national health reform, including insufficient financial resources, shortages of trained staff, particularly clinicians with advanced credentials, and delays in adopting the latest information technology. We recommend that rural states: (1) undertake careful planning for smooth transitions; (2) provide financial resources and technical assistance to expand rural safety-net services and capacity; (3) modify the health home model for the rural context; and (4) engage in ongoing evaluation, which can help ensure the early identification and rectification of unanticipated implementation issues.

The University as Institution and Idea

The University as Institution and Idea Ian Angus (bio) The title of the book, Love the Questions, is taken from Rainer Maria Rilke's Letters to a Young Poet. Speaking to the young Franz Xaver Kappus, who, as it turns out, did not eventually become a poet, Rilke advises him as follows: You are so young, so before all beginning, and I want to beg you, as much as I can, dear sir, to be patient toward all that is unsolved in your heart and to try to love the questions themselves like locked rooms and like books that are written in a very foreign tongue. Do not now seek the answers, which cannot be given you because you would not be able to live them. And the point is to live everything. Live the questions now. Perhaps you will then gradually, without noticing it, live along some distant day into the answer. (34-35) I didn't choose the title, though. We had only a few days before the production deadline, and the great people at Arbeiter Ring Press all pitched in to go through the book and to try to pick out a title. Someone came up with this one, which is a title that reflects what the book is really about. It is a [End Page 21] great experience to publish a book with a group of people who understand it, and stand behind it, making writing and publishing into a shared project. This quotation from Rilke articulates an intense relationship between self-expression and self-knowledge: self-knowledge through self-expression and self-expression through self-knowledge, so that answers pale beside the way of life that is opened up by searching. This is what I call "enlightenment" in the book and which I argue is connected to the essence of university education. At its most basic, enlightenment depends on the notion that one's own view of the world matters, that there is something new and precious about addressing one's experience of the world first-hand, that education—and, indeed, life itself—is not just about fitting into the world but understanding it, acting in it, and changing it. I first went to university in 1967, so it perhaps understandable that I assumed that the university was naturally at the forefront of social criticism and innovation. Gradually, through over thirty years of teaching, I have been disabused of this assumption. Teaching at university has been professionalized, that is, it is seen as just another good middle-class job like a doctor, lawyer, or bank manager, and students see themselves as just suffering through a necessarily extended schooling due to the advanced credentials that a scientific and technical society requires. My practice in the university, however, in everything from teaching to committee work was based on the assumption that the ideals of the university—free inquiry and social reflection—were still valid. I thought of the obvious failures of this ideal in practical situations as just that: failures to realize an ideal that was still valid and, for the most part, operative. Two events led to my asking some basic questions about the structure and function of the contemporary university. First, the violation of the academic freedom of David Noble by the Simon Fraser University administration, 1 and, second, the story about teaching a second-year humanities course that I tell in the book, where the inability of students to understand Rilke's ethic made me wonder if they expected anything like enlightenment from their studies. Rilke advised the young poet that "we must try to assume our existence as broadly as we in any way can; everything, even the un-heard of, must be possible in it" (67). This ethic has expanded beyond poetry and philosophy and into the daily activities of work, marriage, and friendship. It is at the centre of the idea that we should actively live our world and not just be victims of it. I began to wonder if the idea [End Page 22] of enlightenment as self-responsibility any longer had a place in the university. And, if so, what sort of institution was I going to pass on...

Clinical Expertise: A Preliminary Attempt to Clarify Its Core Elements

The recent emphasis on evidence-based practice revolves around an integration of three domains: client characteristics, relevant research, and clinical expertise. Unfortunately, most reports focus on the examination of current research, while few guidelines exist for clarifying or developing expertise in clinical psychology. Although expertise is more advanced than competence, basic clinical competence can set the foundation for the development of more sophisticated skills. It is best to strive for narrow domains of expertise instead of global ratings of a professional as an “expert”. Five criteria are proposed for evaluating, developing, and maintaining clinical expertise: (1) the professional must possess a terminal degree in the field, (2) the professional has accumulated multiple years of clinical experience in the direct provision of clinical assessment, psychological testing, or psychological treatment, (3) the professional has attained advanced credentials in a specific area of psychology, (4) the professional is visible in the professional community at a national level, and (5) the professional has demonstrated evidence of superior clinical skills in a specific application of psychology. Together, these five criteria help to objectify the evaluation and cultivation of clinical expertise in psychology. Because each criterion is weak and flawed if used alone, it is recommended that multiple criteria are used in combination to define clinical expertise.

E-Mentoring Possibilities for Online Doctoral Students: A Literature Review

A growing number of adult learners invest time, energy, and financial resources in completing online doctoral degrees. Several factors, other than the program itself, influence a person's decision to pursue a degree online. Many also choose online learning because they are faced with challenges often typical for adult learners that prohibit them from attending a land-based college campus regularly. A few of these challenges include full-time work (the need to work, and, perhaps, to work shifts or multiple jobs), socioeconomic status, family obligations, physical challenges, and residence in remote geographic locations (Lorenzetti, 2005; Allen & Seaman, 2006; Truluck, 2007). Some research suggests that students may also select online learning after feeling they have experienced racially discriminatory treatment in the land-based classroom (Nance, 2004). The choice to complete an online degree, perhaps for some of the reasons stated, may be evident in rising enrollment and graduation figures for women and people of color in online doctoral education. Recognizing the need for advanced credentials, many private institutions offering online degrees have positioned themselves to meet the educational demands of this growing and diverse population. For example, Diverse: Issues in Higher Education lists Walden Virtual University, which boasts a 30% persons of color population (Nance, 2004), as seventh in the nation for awarding business doctorates to African Americans and in the top 20 for awarding doctorates in psychology to Hispanics (Tosto, 2006). Forty-five percent of Capella students are enrolled in doctoral programs with approximately 66% of that portion comprised of women and 39% people of color (Capella.edu, 2007). Castro (2007) writes, Clearly an online university degree program is a great way to improve your chances of success in your career, but for many minorities, an online degree program is a stepping stone to a better life (para. 5). Among this rising population, several of these online doctoral students expect a sound return on educational investment in the form of a career in higher education. However, studies by Adams and DeFleur (2005), Flowers and Baltzer (2006), Guendoo (2007), and Columbaro (2008) have found that many college and university search committees harbor significant concerns when considering online doctoral degree recipients for academic employment. Throughout these studies, academic employers attributed much of their skepticism to a perceived lack of sufficient faculty-student mentoring in online doctoral programs (Adams & DeFleur, 2005; Columbaro, 2008; Flowers & Baltzer, 2006; Guendoo, 2007). These concerns are reflected in participant comments. One study participant stated, believe mentoring is critical to developing research skills and I am skeptical that adequate mentoring can occur at a 'virtual university' (Adams & DeFleur, 2005, p. 81). This reticence was echoed in a later study: am aware there is potential for several people to pursue an online doctoral program. How will this on-line program prepare the graduates for the professorship without mentorship? (Flowers & Baltzer, 2006, p. 52). As research suggests, academic employers value a candidate's mentoring experiences, while many online doctoral degree students value the convenience of completing their programs from a distance. This article explores the possibilities of e-mentoring for doctoral students completing online programs. Problem Statement and Purpose Research suggests that public perception regarding lack of mentoring opportunities in online doctoral degree programs may create barriers for their graduates' ability to obtain academic employment (Adams & DeFleur, 2005; Columbaro, 2008; Flowers & Baltzer, 2006; Guendoo, 2007). However, there is little research regarding how effective any pre-existing e-mentoring programs are and how well they prepare online doctoral students (particularly women and people of color) for faculty employment. …

Self‐directed (distance) learning infectious disease control MPH program

PurposeThe purpose of this paper is to confirm what program features potential students would view as incentives or disincentives toward enrolling in a unique self‐directed (distance) learning infectious disease control MPH (Master of Public Health) program currently being developed.Design/methodology/approachAn internet discussion list announcement invited infection control professionals to participate in structured telephone interviews. This pilot study survey was conducted to confirm underlying assumptions about program features that might be viewed as incentives or disincentives by prospective students.FindingsResponses were received from all regions of the USA except Alaska. Findings from 78 interviews confirm our underlying assumptions about delivery preferences, critical features, perceived value and reasonable cost for a self‐directed (distance) learning Infectious Disease Control MPH degree. Respondents clearly expressed a preference for distance education, but exhibited lack of familiarity with the various types and relative merits of different distance delivery modalities.Originality/value“Build it and they will come” has long been a widespread assumption in curriculum development. However, continuing education and advanced credentialing needs of health professionals can be better served by executive‐MBA‐style programs. One lesson from examining the experience of our academic MBA colleagues is to know your clients. This study uniquely confirms assumptions about the educational preferences of infection control professionals.

Human Systems Integration in Education and Training: A Grassroots Effort to Obtain Total Systems Performance at an Affordable Cost

AbstractHuman systems integration (HSI) requires highly qualified practitioners who can effectively and affordably integrate human capabilities into new and existing weapons systems. Over the past few years, Congressional support of National Defense Act (HR1522) for HSI continues as evident by this statement, “The committee recognizes HSI initiatives as a means for reducing total ownership costs of weapons programs, and continues to support efforts to more formally consider HSI issues earlier in the acquisition cycle.” To do so, organizations must focus attention within the Joint Capabilities Integration and Development System (CJCSI 3170.01) and the Department of Defense (DoD) acquisition framework (DoDI 5000.2) processes. More specifically, HSI practitioners center attention on total system performance by integrating trade‐offs within and across the HSI domains of manpower, personnel, training, human factors engineering, environment, safety, occupational health, survivability, and habitability. By conducting system‐level integration from concept inception to operational employment to eventual disposal, HSI practitioners can enable optimized total systems performance and reduce life‐cycle costs. Because very few qualified HSI practitioners are available and/or affordable, three critical ingredients need to be addressed: (1) greater demand for HSI as a result of better HSI requirements, (2) senior leadership and organizational motivation of subject matter experts to become HSI practitioners, and (3) availability of comprehensive education and training programs across the spectrum for new personnel to become HSI practitioners and existing practitioners to maintain proficiency and currency with changing technology. Education and training opportunities need to be cohesive and coherent across the spectrum of learning: initial qualification, continuing education, professional development, advanced credentials, and ultimately professional certification. These opportunities should be sufficient to create a near‐term DoD and industry certification standard and process that will support the growing demand for HSI in DoD systems acquisition and the industries that support the process.

Securing an equal role for substance abuse counselors: A commentary on Kerwin, Walker-Smith, and Kirby

Training and credentialing are especially timely issues as the substance abuse field grapples with the challenges of responding to dually diagnosed clients, incorporating empirically supported practices, and preparing for the implementation of results-oriented management. The field has recognized the need for greater workforce professionalism (Campbell, Catlin, & Melchert, 2003) and has made substantial advances in that direction (Mulvey, Hubbard, & Hayashi, 2003), which have been very apparent to those of us working in the field over the past 20 years. However, the study by Kerwin, Walker-Smith, and Kirby (2006) underscores the need to accelerate this process. The study examines only minimum (not advanced) credentials and only state (not private organization) certification/licensure. The study also does not reflect those states that are changing their credential requirements. Nonetheless, this study provides important data for action. Leaders in the substance abuse field can play an essential role in inviting and promoting specific changes to move the field forward. Here I suggest three changes that will be especially important.

The Politics of Teacher Education

Education policy, including teacher education policy, is largely grounded in political and economic arguments, arguments that have to do with power and resources. Most teacher educators I know believe that education policy should be grounded first in moral arguments with a focus on democratic practice and social justice and in educational arguments that lead to high-level understanding and ability to think critically. Many teacher educators, and even deans of education, are not part of process to influence politics affecting education of educators, perhaps because they find process distasteful (it sometimes is), do not understand how to act politically, or continue to use moral and educational arguments. Acting politically and morally are not necessarily mutually exclusive concepts. For past decade or more, I have tried to influence deans of education and other educational leaders to become active in shaping policy affecting teacher education, and it is, of course, policy that is focus of politics of teacher education. In Policy Paradox: The Art of Political Decision Making, Stone (2002) argued that we are in error if we think of policy formation as rational. Instead, Stone argued that the very categories of thought underlying rational analysis are themselves a kind of paradox, defined in political struggle. They do not exist before or without politics, and because they are necessarily abstract, they can have multiple (pp. 8-9). A good example of paradox, and multiple meanings embedded in a political struggle, is concept of a qualified For first time in our history, we have a legal definition of a highly qualified teacher. In No Child Left Behind Act of 2001 (NCLB), definition for a highly qualified teacher in any public elementary or secondary school is that generally, teacher has met state certification requirements (including alternate routes), passed state tests, and has a high level of competency in academic subjects taught measured by an appropriate major or advanced credentialing (NCLB, 2001, pp. 544-545). And so, a highly qualified teacher knows his or her content, and we know that this is so because he or she has either passed a test, has an academic major, graduate degree, equivalent coursework, or advanced certification or credentialing. (Note that there is a nod to teaching skills for new elementary teachers.) In his review of research on teaching, former Secretary of Education Rod Paige (U.S. Department of Education, 2003) concluded that although individual teachers make an enormous difference in student achievement, we do not know which attributes matter. Furthermore, Paige cited research that although teacher experience and content knowledge are linked to student achievement, training in pedagogy or field experiences or master's degrees have not been linked to student success, nor have certification requirements. Curiously, meeting state certification standards is one of standards for identifying highly qualified teachers (U.S. Department of Education, 2003, p. 2). Of course, there is a great deal of other research that counters this limited perspective that quality depends on content knowledge and two other variables not seemingly in NCLB-cognitive ability and length of service (see, e.g., Darling-Hammond, 2000; Darling-Hammond & Sykes, 2003; Wilson, Floden, & Ferrini-Mundy, 2001). Why would policy reflect such a narrow definition of qualities we would look for in a highly qualified teacher? Why would policy allow one to demonstrate that quality of academic content knowledge by so many means--a test, a major, an equivalence of a major, state certification (a quality secretary is not confident in)? I think I know. Not too long ago, a senior member of Bush administration's education hierarchy (who will remain nameless) met with a group of researchers who were, in part, debating meaning of having highly qualified teachers for every child--seemingly a core goal of NCLB. …

Relying Party Credentials Framework

We present architecture for a relying-party to manage credentials, and in particular to map different credentials into common format and semantics. This will allow use of simple, widely available credentials as well as more advanced credentials such as public key certificates, attribute certificates and ‘negative’ credentials (which result in reduced trust) such as certificate revocation lists (CRL). The core of the architecture is a Credential Manager who collects credentials, and maps them to common format and semantics.

Reflections on the continuing evolution of advanced practice nursing

While the concept of advanced practice nursing (APN) is still relatively new, distinct patterns of evolution from specialty practice to advanced practice nursing are evident over the last 100 years. The purpose of this article is to describe 3 stages in this evolutionary process, as well as discuss several internal and external issues that represent challenges facing APN educators and clinicians who seek to strengthen advanced practice in the current healthcare system. We clarify our definition of advanced practice nursing, and note the critical need for cohesion within the profession regarding the definition and core competencies of advanced practice. Our aim is to suggest a preferred vision for advanced credentialing. We encourage dialogue among our nursing colleagues to move this agenda forward.

Ultrasound in Surgical Practice: Basic Principles and Clinical Applications

It is my privilege to review Ultrasound in Surgical Practice, a roughly 500 page illustrated textbook by a surgeon and sonographer at the foreground of surgical ultrasound. This book is organized into 18 chapters by anatomical region. Fifteen of the 24 contributors are surgeons, including three with advanced credentials from the American Registry of Diagnostic Medical Sonographers.