Rehabilitation Competency Research Articles

Entry-to-Practice Rehabilitation Competencies and the Rehabilitation Competency Framework: A Gap Analysis

ObjectivesThe demand for rehabilitation services is rising globally, necessitating a well-prepared and diverse rehabilitation workforce. The World Health Organization developed the Rehabilitation Competency Framework (RCF) to guide the development of contextually based competencies for various rehabilitation professions. This study systematically compared the entry-level competencies of different rehabilitation professions with the RCF, thereby discerning commonalities and gaps. By exploring these comparisons, the aim was to identify overlapping competencies and areas for collaboration, potentially informing the creation of unified educational materials to support the development of rehabilitation professionals. DesignThe competence frameworks of audiology, occupational therapy, physical and rehabilitation medicine, psychology, physiotherapy, prosthetics and orthotics, rehabilitation nursing, and speech and language therapy were researched online. In cases where international standards or competencies were unavailable online, expert colleagues in the related field were consulted to confirm the absence of an international document. A nationally recognized and freely available document was selected to represent the profession if no international document was found. The frameworks were then mapped to the RCF domains. SettingDesk-based research. ParticipantsNot applicable. InterventionsNot applicable. Main Outcome MeasuresNot applicable. ResultsThe professional documents demonstrated a stronger alignment with the competencies outlined in the RCF activities. The practice and professionalism domains showed the greatest congruence with profession-specific competencies, whereas the learning and development, management and leadership, and research domains had varying levels of alignment. This consistency in mapping may be attributed to the profession-specific competencies’ focus on the fundamental entry-level knowledge, skills, values, and abilities essential for delivering safe and effective patient care. ConclusionsThe mapping exercise revealed that competencies in the profession-specific frameworks primarily focused on individual-level skills for effective patient care rather than societal-level impact, such as acting as rehabilitation advocates. The study provides valuable insights into the alignment between profession-specific competencies among the rehabilitation professions. Identifying commonalities and gaps can facilitate the development of shared educational resources for foundational support across diverse rehabilitation disciplines. This effort can contribute to building a robust and unified rehabilitation workforce capable of meeting the emerging health needs of diverse populations worldwide.

Setting the European standards for training in Physical and Rehabilitation Medicine.

The mission of the European Board of Physical and Rehabilitation Medicine (PRM) is to the ensure a consistent and high-level education for PRM physicians across Europe. An important action to accomplish this mission is the publication and continuous update of the European Training Requirements (ETRs) for the specialty of PRM. The first version of the ETRs for PRM was issued in 2017. The aim was to present the up-to-date training standards for trainees, trainers, and training institutions. The revision of the first ETRs, aiming to reflect the current standards in medical education and clinical advances in the field or PRM, started in 2022 and was completed in 2023. It was based on the Rehabilitation Competency Framework and the "Guide for using a contextualised competency framework to develop rehabilitation programmes and their curricula" published by the WHO in 2021. An important addition in the new version of the ETRs is the integration of Entrustable Professional Activities. In all endeavours of the creation of the ETRs, setting the highest standards of training in PRM was pursued.

Proposing an Interprofessional Competency Framework for Person-Centered Care Connecting Interprofessional Education and Collaborative Practice

Introduction: The number of complex healthcare problems is increasing, the workforce is diminishing, and healthcare costs are rising. Interprofessional Education and Collaborative Practice is a promising solution, necessitating the cultivation of skills and competencies among health and social care professionals. The central question guiding this study revolves around the possibility of merging interprofessional collaboration, lifelong learning, the International Classification of Functioning, Disability and Health (ICF), and the Rehabilitation Competency Framework (RCF) into a unified competency framework that can be used in both education and in the work field. Method: In total, five modified Delphi rounds were executed during three phases specifically comprising the design, relevance, and report stages. The first contains a literature search, the second includes 11 pilots with surveys, and the last finalized the INPRO Competency Framework (INPRO CF). Results: The primary result is the INPRO CF that is readable, accurate, applicable, and accepted. It contains five domains, 17 competencies, and 200 learning outcomes or behaviors. It exists in four languages (Dutch, Finnish, English, German). Discussion: The INPRO CF is a relevant interprofessional competency framework designed to alleviate deficiencies between education and practice so it is suitable for a lifelong learning process. It demonstrates adaptability across various contexts. Implications for Practice The INPRO Competency Framework provides a structured overview of the learning journey in becoming an experienced interprofessional collaborator and is applicable in both practice and educational settings. The INPRO Competency Framework provides a comprehensive understanding of goals that an individual in a team can work on and structures those that it would like to achieve. The INPRO Competency Framework has the potential to positively impact person centered care by promoting collaboration among health and social care professionals. It simultaneously can contributes to transforming education by shaping curricula and preparing students for interprofessional teamwork in their future careers.

Developing consensus-based clinical competencies to guide stroke clinicians in the implementation of psychological care in aphasia rehabilitation.

Background People with aphasia experience depression and anxiety associated with negative outcomes across a range of time post-stroke. Stroke clinicians are well-positioned to facilitate low-intensity psychotherapeutic interventions after aphasia (e.g. mood screening, behavioural activation, problem-solving therapy, relaxation therapy); however, they self-report a lack of knowledge, skills and confidence to do so. The Theoretical Domains Framework (TDF) provides a lens through which to view and target clinician behaviours and training needs in this area of practice. The aim of this study was to develop and gain consensus on items for a rating scale of clinical competencies in facilitating individual-based, low-intensity psychotherapeutic interventions for people with aphasia. Methods An e-Delphi methodology using focus groups and survey rounds was used to gain consensus on clinical competencies considered important. Results Eight stroke clinicians (speech pathologists and psychologists), two people with aphasia and three family members participated in one of four focus groups. Four themes were derived from the data: (1) Communication support, (2) Assessment and therapy structure, (3) Interpersonal skills, and (4) Needs of the significant other (family or friend). Themes informed an initial list of 23 self-rated and observer-rated competency items. Following two rounds of e-Delphi surveys, 11 stroke clinicians (six speech pathologists and five psychologists) reached consensus (80-100%) for 19 competencies. Conclusions The Psychological Care in Aphasia Rehabilitation Competency scale offers a preliminary list of items to guide and train clinicians to implement low-intensity psychotherapeutic interventions for people with aphasia.

World Health Organization Rehabilitation 2030: Call to Action Update.

The Rehabilitation 2030: Call to Action initiative highlighted the global unmet need for rehabilitation services and the importance for enhancing health systems in low- and middle-income countries to deliver these services. Dedicated interprofessional volunteers, such as Association of Rehabilitation Nurses (ARN) nurse leaders, have been integral in working with the technical groups to develop the World Health Organization Rehabilitation Competency Framework and the Package of Interventions for Rehabilitation. These resources are available for countries to "adopt and adapt." The recent launch of the World Rehabilitation Alliance is important to note as they support the Rehabilitation 2030's mission through advocacy activities and offers an opportunity for further ARN involvement.

Competencies of undergraduate physiotherapy education: A scoping review.

In recent years, the need for competency-based medical education has been emphasised. Each country needs a defined set of physiotherapy competencies from the associations and governing bodies. Our review aimed to map competencies of undergraduate physiotherapy education and propose a context-specific competency framework for Namibia. This scoping review was conducted following the Joanna Briggs Institute framework and was reported using the Preferred Reporting for Systematic Reviews and Meta-analysis Extension for Scoping Reviews. Qualitative direct content analysis utilising the five main competency domains from the WHO Rehabilitation Competency Framework was adapted. Five main competency domains were proposed: practice, professional growth and involvement, learning and development, management and leadership, and research. Nineteen potential competencies were identified, and each competency has a set of knowledge and skills activities that is expected of each student. The proposed competencies still need to undergo expert consensus and content validation before they can be adopted and implemented in Namibia. Future studies can explore the perspectives and experiences of the faculty, students and clinicians on the current status of competency-based education of undergraduate physiotherapy programme in Namibia. Similarly, future studies can focus on possible assessment strategies that can be used for each competency and an evaluation framework for assessing milestones in student competencies from entry into clinical education to graduation. The review proposed a context-specific competency framework for Namibia with a set of knowledge and skills activities that is expected of each student. The faculty can adopt these competencies and improve on their competency-based physiotherapy education.

71 Burn Intensive Care Unit Early Mobility Competency Based Orientation

IntroductionCompetencies in healthcare are used to teach practice standards, to establish expectations for professional growth, and to evaluate and improve the effectiveness of educational programs. Benefits of early mobilization of Burn Intensive Care Unit (BICU) patients include improved ICU related weakness and delirium, range of motion, and decreased length of stay while promoting functional independence. A rehabilitation competency was developed for early mobility with the patient in the BICU using nationally agreed-upon standards for competence. By design this competency for BICU early mobility is part of a tiered training structure, with the burn rehabilitation and pediatric competencies serving as additional tiers of burn therapist training at our organization. The goal of this competency is to provide direct therapist training, including alignment with the inter-professional team involved with this intervention.MethodsA pretest was issued regarding BICU early mobility competency. The pretest asked the therapist to indicate their perceived level of competence in the areas of functional mobility, indications and contraindications of BICU early mobility, Respiratory Care Provider (RCP) protocols and documentation of BICU early mobility. Based on the results of this pretest, it was identified that BICU early mobility would be prioritized as the next training tier. The BICU Early Mobility Competency was created in Competency Based Orientation (CBO) format, including nationally agreed-upon standards for burn therapist competence. The method of this training is designed to occur with an ongoing patient case study for validation, with the CBO as the teaching tool.ResultsCreation of this competency as part of a tiered training allows our burn center to have an educational program which aligns with the nationally agreed-upon standards for burn therapist competence. Creation of this competency resulted in direct communication channels between rehabilitation, RCP, nursing and physician teams.ConclusionsThis tiered system allows for time management of the validator signing off on competencies, and encourages use of current resources and literature in the areas of burn therapist competence and professional development.

Global Certification: A Transformative Approach to Building the World’s Rehabilitation Health Workforce

To meet the needs of the 2.41 billion people seeking rehabilitation care, the world’s health workforce must be sustainable and scalable. In 2021, the WHO launched its Rehabilitation Competency Framework (RCF) to help countries build local rehabilitation ecosystems by focusing on high-level priorities. A top priority is the development of a health workforce that is sustainable and scalable to meet local needs. To capitalize on existing health workforce resources, countries need to focus on the specialists and on other members of the rehabilitation team who can assume targeted responsibilities for delivering care. To support these efforts, CGFNS International, Inc., an assessment organization for health professionals worldwide, is developing two exam-based global certifications, one for rehabilitation health workers and one for registered nurses working in rehabilitation settings. These global certifications assess the knowledge and competencies of individual rehabilitation health workers and nurses and certify those who meet the standards. For consumers, global certification attests to the competence of local service providers and helps ensure quality care. For health workers and nurses, global certification confers a credential that recognizes their expertise and supports their continuing professional development and career goals. And for policymakers, global certification provides useful information for managing care delivery. This article provides the rationale behind global certification, describes the methodology for creating these certifications, and shows how their underlying constructs and those of the WHO’s RCF align. This alignment helps consumers, health workers and nurses, and local authorities use all available tools to make informed decisions advancing rehabilitation care.

Research on teaching reform of rehabilitation nursing major based on modern apprenticeship system†

Abstract Objective To determine the specific indicators of nursing students’ competency in rehabilitation nursing posts; to form a training mode of competency of nursing students in rehabilitation nursing posts based on a modern apprenticeship system; and to preliminarily explore the effect of this training mode. Methods The literature review method and the Delphi method were used to determine the specific indicators of nursing students’ competency in rehabilitation nursing posts. Based on the competency index results, the training mode of modern apprenticeship in rehabilitation nursing specialty was determined. Taking a university as an example, the modern apprenticeship training model of rehabilitation nursing specialty was put into the operation group, and the students were selected into the experimental group. The nursing students who accepted the traditional training mode were selected as the control group to compare the competency of the two groups of nursing students before graduation. Results Form a total of 191 indicators of nursing students rehabilitation nursing post competency content. The competency scores of nursing students in the rehabilitation nursing posts of the experimental group were higher than those in the control group in 24 work tasks, and the difference was statistically significant (P < 0.05). Conclusions Based on the modern apprenticeship system, the training model of nursing students’ competency in rehabilitation nursing posts could improve the matching degree of nursing posts of nursing students and may provide a reference for improving the training of rehabilitation nursing talents.

Collaborative effort to increase the physiotherapist’s competency in rehabilitation of torture survivors

Thank you for this opportunity to share perspectives from our work within the Physiotherapy and Refugees Education Project, PREP, an Erasmus+ funded project within the KA2 strategic partnership program. Researchers, educators, students, and clinicians within institutions of higher education, health services and humanitarian organisations, have worked together in this project to define competencies that physiotherapists need in working with refugees. Based on this, we have made a course openly available for physiotherapists worldwide. A central aim of the work in PREP has been the creation of a network in which educators, students and clinicians can meet, discuss, and learn from each other. We welcome everyone who shares our interest to join us in this network. In this perspective paper, we want to share our thoughts and opinions on how such a collaboration can be used for building competence. We will discuss topics that are central for physiotherapists working with victims of torture, and finally, we will discuss what we believe are the important next steps within physiotherapy to be able to support this group.

Development and Validation of the WHO Rehabilitation Competency Framework: A Mixed Methods Study

ObjectivesTo identify the competencies, behaviors, activities, and tasks required by the rehabilitation workforce, and their core values and beliefs, and to validate these among rehabilitation professionals and service users. DesignMixed methods study, involving a content analysis of rehabilitation-related competency frameworks, a modified Delphi study, and a consultation-based questionnaire of service users. SettingDesk-based research. ParticipantsParticipants who completed the first (N=77; 47%) and second (N=68; 67%) iterations of the modified Delphi study. Thirty-seven individuals participated in the service user consultation. Collectively, the participants of the mixed methods study represented a significant range of rehabilitation professions from a broad range of countries, as well as both high- and low-income settings. InterventionsNot applicable. Main Outcome MeasuresNot applicable. ResultsThe mixed methods study resulted in the inclusion of 4 core values, 4 core beliefs, 17 competencies, 56 behaviors, 20 activities, and 62 tasks in the Rehabilitation Competency Framework. The content analysis of rehabilitation-related competency frameworks produced an alpha list of competencies, behaviors, activities and tasks (“statements”), which were categorized into 5 domains. The final iteration of the modified Delphi study revealed an average of 95% agreement with the statements, whereas the service user consultation indicated an average of 87% agreement with the statements included in the questionnaire. ConclusionsDespite the diverse composition of the rehabilitation workforce, this mixed methods study demonstrated that a strong consensus on competencies and behaviors that are shared across professions, specializations, and settings, and for activities and tasks that collectively capture the scope of rehabilitation practice. The development of the Rehabilitation Competency Framework is a pivotal step toward the twin goals of building workforce capability to improve quality of care and strengthening a common rehabilitation workforce identity that will bolster its visibility and influence at a systems-level.

Modeling the Formation Process Physical and Healthy Competence Future Atomic Specialists

The authors of this work formulated in their studies the content of the concept of physical fitness and health competence of future specialists in the nuclear industry as an integral characteristic of a person, reflecting the formation of recreational and health and rehabilitation competencies; competencies in the field of maintaining a healthy lifestyle; possession of means of independent, methodically competent use of methods of physical education and health promotion, in addition, its structural components are determined on the basis of a systematic approach. At the same time, the introduced definition is the starting point for the continuation of the further scientific search for an effective model for the formation of sports and fitness competence of future specialists in the nuclear industry. The presented study is devoted to the design and theoretical substantiation of the structural-functional model of the process of formation of fitness and fitness competence of these specialists. Moreover, models are a demonstrative tool for the functioning of a certain object (system), illustrating the basic norms and rules of its behavior. The methodological basis of the study was made up of pedagogical modeling, systemic, activity-based, interdisciplinary, integrative and competency-based approaches. The principles on the basis of which the formation of the studied competency is carried out are determined: systematic and systematic; professional orientation, developing and educating training, science and communication with practice; combination of individual and collective forms of learning, integrativity. A structural and functional model for the formation of physical fitness and health competence of future specialists in the nuclear industry has been developed and theoretically justified, including interdependent and interconnected blocks: target, theoretical, methodological, structural and functional, substantive-technological, resultant-criterion, correctional and managerial, as well as block pedagogical conditions, designed to ensure the effective formation of this competency.

Rehabilitation in the core graduate medical curricula at university of São Paulo school of medicine: The student's perception

Rehabilitation is a key health strategy for the 21st century. Increase the number of medical graduates aware of rehabilitation competencies and skills is a success indicator of strengthening and extending the provision of rehabilitation services. Our objective was to evaluate a novel teaching method to third year medical students based mostly in student-centered techniques. This course was offered at Faculdade de Medicina da Universidade de São Paulo, Brazil. One hundred sixty-eight third year medical students responded an anonymous survey evaluating their perception of a 12-hour discipline on Rehabilitation. The Discipline was developed collaboratively in the 2017 Medical Teaching and Learning Innovation Program. Teaching materials were available to students at an educational platform to promote interaction and collaboration. The didactic curriculum was presented in the case-method format. Students performed the anamnesis and physical examination, with emphasis on the functional semiology, developing a treatment plan with functional goals, under the supervision of physical and rehabilitation medicine specialists, who mentored the activities. Members of the multidisciplinary team participated in the discussions. Rehabilitation interventions were performed as needed. Students were requested to produce and to present a mental map of the evaluated cases. 95.3% of the students responded the anonymous survey. 88.2% of the responding students considered rehabilitation as an important discipline in medical training. For 90.8% of the students, the overall assessment for the course was “very good” or “good” and 59.6% requested the increase in its duration. Third year medical students perceive rehabilitation as an important discipline in medical education. The overall assessment for the course was “very good” or “good”, and there is a request for the increase in its duration from more than half of the students. Improvement of course methodology in rehabilitation may improve to attract more medical students to rehabilitation specialty.

A Pragmatic Approach to Cultural Competency in Vocational Rehabilitation: The Case of Hmong Americans

Rehabilitation counselors face a complex challenge in achieving the standard of cultural competence among vocational rehabilitation (VR) consumers from all backgrounds. The purpose of this paper is to explicate an achievable approach to culturally competent VR counseling with VR consumers from Culturally and Linguistically Diverse (CLD) backgrounds. The multifaceted and contextual nature of cultural and linguistic diversity can pose challenges to both the agency and the counselor. The challenge of accurately assessing culturally relevant outcomes has obscured the value of culturally competent counseling practices. The authors propose a pragmatic approach to cultural competency based on a combination of existing cultural competency models-the Cultural Equivalence Model and Bernal's approach to the Cultural Variance Model. A detailed working example of how to use this approach with a low incidence CLD group, Hmong Americans, is provided.

The Effect of Advanced Practice Nurse-Modulated Education on Rehabilitation Nursing Staff Knowledge

Rehabilitation is a specialty area with defined competencies and discrete nursing knowledge. Nurses need to be educated in the basic competencies of rehabilitation to provide safe, quality care to patients with chronic illnesses and disabilities. A critical appraisal of the literature showed that education increased knowledge in a specialty area and had positive benefits for nurses, organizations, and patients. The purpose of this paper is to describe an evidence-based educational intervention. Self-study modules on 15 rehabilitation competencies were developed for 16 nurses working on a new inpatient unit. Outcomes were evaluated using pre and post tests via the online Association of Rehabilitation Nurses (ARN) Competency Assessment Tool (CAT). Data were analyzed using the SPSS14.0 statistical package. Paired t-tests demonstrated a significant difference between pre and post test scores on 14 of the 15 competencies measured. Findings suggested that education of nursing staff resulted in increased knowledge about rehabilitation nursing competencies.

Competency of Psychiatric Residents in the Treatment of People With Severe Mental Illness Before and After a Community Psychiatry Rotation

psychiatric rehabilitation is an evidence-based service with the goal of recovery for people with severe mental illness. Psychiatric residents should understand the services and learn the principles of psychiatric rehabilitation. This study assessed whether a 3-month rotation in a psychiatric rehabilitation center changes the competency level of second-year psychiatric residents in evidence-based treatment of severe mental illness. the study is a prospective, case-control comparison using the validated Competency Assessment Instrument (CAI), which measures 15 provider competencies critical to recovery, rehabilitation, and empowerment for people with severe mental illness, providing a score for each competency. Participants were second-year psychiatric residents attending a 3-month rotation at the Community Reintegration Program, a psychiatric rehabilitation day program. The authors administered the CAI at the beginning and the end of the residents' 3-month rotation in order to assess change in their competency in psychiatric rehabilitation. The authors also administered the CAI to a comparison group of second-year psychiatric residents who did not rotate through the Community Reintegration Program, and therefore had no formal training in psychiatric rehabilitation. a 3-month rotation in psychiatric rehabilitation significantly improved residents' competency in the domains of goal functioning, client preferences, holistic approach, skills, and team value relative to nonrotating residents. a brief community psychiatry rotation in the second year of residency likely improves some skills in the treatment of people with severe mental illness. Future research should evaluate year-long electives and public psychiatry fellowships.

Evolution of vocational rehabilitation competencies in Australia

Over the past decade, there has been growth in the delivery of vocational rehabilitation services globally, as countries seek to control disability-related expenditure, yet there has been minimal research outside the United States on competencies required to work in this area. This study reports on research conducted in Australia to determine current job function and knowledge areas in terms of their importance and frequency of use in the provision of vocational rehabilitation. A survey comprising items from the Rehabilitation Skills Inventory-Amended and International Survey of Disability Management was completed by 149 rehabilitation counselors and items submitted to factor analysis. T-tests and analyses of variance were used to determine differences between scores of importance and frequency and differences in scores based on work setting and professional training. Six factors were identified as important and frequently used: (i) vocational counseling, (ii) professional practice, (iii) personal counseling, (iv) rehabilitation case management, (v) workplace disability case management, and (vi) workplace intervention and program management. Vocational counseling, professional practice and personal counseling were significantly more important and performed more frequently by respondents in vocational rehabilitation settings than those in compensation settings. These same three factors were rated significantly higher in importance and frequency by those with rehabilitation counselor training when compared with those with other training. In conclusion, although 'traditional' knowledge and skill areas such as vocational counseling, professional practice, and personal counseling were identified as central to vocational rehabilitation practice in Australian rehabilitation agencies, mean ratings suggest a growing emphasis on knowledge and skills associated with disability management practice.

Audiologic Rehabilitation Competency Document Nears Completion

Audiologic Rehabilitation Competency Document Nears Completion

Certification and measuring competency in physical medicine and rehabilitation in Canada

Anton H. Certification and measuring competency in physical medicine and rehabilitation in Canada. Arch Phys Med Rehabil 2000;81:1253-5. © 2000 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Endorsement of Professional Multicultural Rehabilitation Competencies and Standards

This article proposes specific multicultural rehabilitation competencies and standards that define a professional culturally competent rehabilitation counselor. Cross-cultural skills are based on three characteristics across three dimensions: beliefs and attitudes, knowledge, and skills. Explanatory statements operationalizing each competency area are offered. In reinforcing the need and rationale for a multicultural perspective in rehabilitation counseling and rehabilitation education programs, the authors urgently appeal to the leadership of professional rehabilitation organizations to infuse multiculturalism throughout their organizations. Specific recommendations toward endorsement of the proposed competencies are set forth.