Competency and capacity : the legal and medical interface

Balancing the competing interests of autonomy and protection of individuals is an escalating challenge confronting an ageing Australian society. Legal and medical professionals are increasingly being asked to determine whether individuals are legally competent/capable to make their own testamentary and substitute decision-making, that is financial and/or personal/health care, decisions. No consistent and transparent competency/capacity assessment paradigm currently exists in Australia. Consequently, assessments are currently being undertaken on an ad hoc basis which is concerning as Australia’s population ages and issues of competency/capacity increase. The absence of nationally accepted competency/capacity assessment guidelines and supporting principles results in legal and medical professionals involved with competency/capacity assessment implementing individual processes tailored to their own abilities. Legal and medical approaches differ both between and within the professions. The terminology used also varies. The legal practitioner is concerned with whether the individual has the legal ability to make the decision. A medical practitioner assesses fluctuations in physical and mental abilities. The problem is that the terms competency and capacity are used interchangeably resulting in confusion about what is actually being assessed. The terminological and methodological differences subsequently create miscommunication and misunderstanding between the professions. Consequently, it is not necessarily a simple solution for a legal professional to seek the opinion of a medical practitioner when assessing testamentary and/or substitute decision-making competency/capacity. This research investigates the effects of the current inadequate testamentary and substitute decision-making assessment paradigm and whether there is a more satisfactory approach. This exploration is undertaken within a framework of therapeutic jurisprudence which promotes principles fundamentally important in this context. Empirical research has been undertaken to first, explore the effects of the current process with practising legal and medical professionals; and second, to determine whether miscommunication and misunderstanding actually exist between the professions such that it gives rise to a tense relationship which is not conducive to satisfactory competency/capacity assessments. The necessity of reviewing the adequacy of the existing competency/capacity assessment methodology in the testamentary and substitute decision-making domain will be demonstrated and recommendations for the development of a suitable process made.

The professional identity of child care practitioners : self-authorship as a theoretical framework

This research contributes new understandings about the development of the professional identity of child care practitioners and how professional identity changes during the transition from student to practitioner. Self-authorship theory was used as the framework to investigate the development of professional identity through exploration of beliefs about practice, sense of self, and capabilities for collaborative engagement. Students recruited for this research were completing their qualifications to work with young children in child care settings. Data from initial and follow-up interviews were analysed to understand change over time in professional identity. Findings indicated a need for training institutions and workplaces to move beyond competency-based training approaches to include more critically reflective learning opportunities. Such a focus on critical reflection has implications for improving the skills, status, and recognition of child care practitioners as educators.

Innovations in dietetic training in foodservice management : can early exposure to practice enhance final year competency development?

Student engagement in the delivery of theoretical course materials is a current challenge in the tertiary sector including for dietetic training. In 2011 with the creation of a new nutritionist position for Queensland Meals on Wheels (QMOW), a service learning approach to support this organisation was used with third year dietetic students undertaking two days of structured activities at various QMOW sites in South East Queensland, aligned with coursework in Foodservice Management (FSM). This cohort of students was then followed in their final year post successful completion of five weeks professional practice in FSM to see if this experience supported readiness for placement and competency development. Evaluation was undertaken of eligible students (n = 50) via paper based survey (response rate 94%) with all participating in targeted focus groups. Findings showed that students acknowledged the QMOW experience (on reflection 14 months later) providing opportunity for participation and/or observation in 5 of 12 FSM areas taught in third year, including food safety, meal production, assembly, delivery and dishwashing. Over half the students identified good exposure to FSM competency areas during the QMOW experience, with 83% satisfied with their competency exposure and subsequent practice during final year placements. A consistent theme emerged from focus groups supporting inclusion of practical opportunities with the theoretical component of the FSM subject to highlight relevance to learning. These findings highlight the importance of such teaching initiatives to met student learning preferences, linking theory with practice and supporting competency development in the final year of training programs.

Understanding advanced and extended professional practice

The Advanced Pharmacy Practice Framework Steering Committee (now replaced by the Pharmacy Practitioner Development Committee) undertook work to develop an advanced pharmacy practice recognition model. As part of that work, and to assure clarity and consistency in the terminology it uses, the Committee collated the definitions used in literature sources consulted. Most recently, this involved a review of the meaning attributed to the terms ‘advanced’ and ‘extended’ when used in the context of describing aspects of professional practice. Both terms encompass the acquisition of additional expertise. While ‘advanced’ practice involves the acquisition of additional expertise to achieve a higher performance level, ‘extended’ practice relates specifically to scope of practice and involves the acquisition of additional expertise sufficient to provide services or perform tasks that are outside the usual scope of practice of the profession. Performance level operates independently of scope of practice but both must be elucidated to fully describe the professional practice of an individual practitioner.

An entrepreneurial music industry education in secondary schooling: The emerging professional learning model

There is widespread agreement that entrepreneurial skills are crucial for young people today, yet there are few studies of high school students engaging in entrepreneurship education that might prepare them for music industry careers. This study has been developed in response to these challenges. It explores a group of high school students (15 – 17 years) who alongside their teacher, have co-designed, developed and driven a new business venture, Youth Music Industries (YMI) since 2010. This venture staged cycles of differently scaled events featuring young artists for a young audience. The project was designed to give students a real business situation for developing their project management skills and a broader understanding of working in the music industry. Informed by concepts of social capital and communities of practice, the study examines the process of learning with and through others. This high-stakes environment increased their sense of presence and participation and made it possible for these young people to distribute expertise and learn from each other in a reciprocal and more democratic way. The ongoing success of this organisation can be attributed to the entrepreneurial competencies students developed. The resulting model and design principles talk to an ongoing challenge that has been identified in music education, and creative industries more generally. These principles offer a way forward for other music and creative industries educators or researchers interested in developing models of, and designs for, nurturing an entrepreneurial mindset.

Methodology for developing competency standards for dietitians in Australia

Competency standards document the knowledge, skills, and attitudes required for competent performance. This study develops competency standards for dietitians in order to substantiate an approach to competency standard development. Focus groups explored the current and emerging purpose, role, and function of the profession, which were used to draft competency standards. Consensus was then sought using two rounds of a Delphi survey. Seven focus groups were conducted with 28 participants (15 employers/practitioners, 5 academics, 8 new graduates). Eighty-two of 110 invited experts participated in round one and 67 experts completed round two. Four major functions of dietitians were identified: being a professional, influencing the health of individuals, groups, communities, and populations through evidence-based nutrition practice, and working collaboratively in teams. Overall there was a high level of consensus on the standards: 93% achieved agreement by participants in round one and all revised standards achieved consensus on round 2. The methodology provides a framework for other professions wishing to embark on competency standard review or development.

Digital competence and professional development of vocational education and training teachers in Queensland

Teaching with digital technologies is essential to the development of 21st century students’ graduate capabilities. However, relatively little is known about the extent to which Queensland VET teachers engage with digitally-enhanced teaching, or have the capacity to do so. Using a mixed methods approach, this thesis investigated the current digital teaching capacities of VET teachers and how current professional development opportunities are helping to address their learning needs.

Governance of enterprise Information and Technology: A new core competency for boards of directors

With the level of digital disruption that is affecting businesses around the globe, you might expect high levels of Governance of Enterprise Information and Technology (GEIT) capability within boards. Boards and their senior executives know technology is important. More than 90% of boards and senior executives currently identify technology as essential to their current businesses, and to their organization’s future. But as few as 16% have sufficient GEIT capability. Global Centre for Digital Business Transformation’s recent research contains strong indicators of the need for change. Despite board awareness of both the likelihood and impact of digital disruption, things digital are still not viewed as a board-level matter in 45% of companies. And, it’s not just the board. The lack of board attention to technology can be mirrored at senior executive level as well. When asked about their organization’s attitude towards digital disruption, 43% of executives said their business either did not recognise it as a priority or was not responding appropriately. A further 32% were taking a “follower” approach, a potentially risky move as we will explain. Given all the evidence that boards know information and technology (I&T***) is vital, that they understand the inevitably, impact and speed of digital change and disruption, why are so many boards dragging their heels? Ignoring I&T disruption and refusing to build capability at board level is nothing short of negligence. Too many boards risk flying blind without GEIT capability [2]. To help build decision quality and I&T governance capability, this research: • Confirms a pressing need to build individual competency and cumulative, across-board capability in governing I&T • Identifies six factors that have rapidly increased the need, risk and urgency • Finds that boards may risk not meeting their duty of care responsibilities when it comes to I&T oversight • Highlights barriers to building capability details three GEIT competencies that boards and executives can use for evaluation, selection, recruitment and professional development.