Current Recommendations For Reform in Education For Health Professionals
Current Recommendations For Reform in Education For Health Professionals
Current Recommendations For Reform in Education For Health Professionals
Chiclayo, Peru
October 24, 2012
Greetings from
Pennsylvania
Greetings from
Philadelphia
University of Pennsylvania
Established in 1740
School of Nursing
Established in 1935
Transformation of Education in
the Health Sciences
Principles
Progressive Development
Integrative Learning (research/teaching)
Collaborative Learning
Apprenticeship with several mentors
Creating and nurturing an intellectual
community
Shared purpose
Diverse and multigenerational
Flexible and forgiving
Respectful and generous
Meaningful dialogues
(Walker et al 2008)
PhD Education
Educate for highest levels of
competency and integrity
Educate for generation, conservation,
and transformation of a discipline
Understand that modern science must
confront epistemological issues of
knowledge and knowing
Interdisciplinary education is the
future
Educate for different roles
Report
Competencies
Identified by Professional
Organizations
(e.g. oncology, palliative
care, CV)
Specialty Certification*
Specialty
Population Foci
Role
APRN
Licensure: based
on Education
And certification**
APRN Legislative
Language
Prescriptive Authority
Independent Practice
Use of Dr. title
Recognition at role and population focus level
No temporary permit
Definition of APRN
Consensus Model
APRNs
Consensus Model
GOAL
Development of
LACE (Licensure,
Accreditation,
Certification, and
Education) as an
integrated
educational and
regulatory
model.
Licensure occurs at
Levels of Role &
Population Foci
APRN Specialties
Focus of Practice beyond role and population focus
Linked to health care needs Examples include but are not limited to:
Oncology, Older Adults,
Orthopedics, Nephrology, Palliative care
POPULATION FOCI
Family/Individual
Across lifespan
AdultGerontology
Womens Health/
Gender Related
Neonatal
Pediatrics
Psych/Mental
Health
APRN ROLES
Nurse
Anesthetist
Nurse
Midwife
Clinical Nurse
Specialist ++
Nurse
Practitioner +
+The certified nurse practitioner (CNP) is prepared with the acute care CNP competencies and/or the
primary care CNP competencies. At this point in time the acute care and primary care CNP delineation
applies only to the pediatric and adult-gerontology CNP population foci. Scope of practice of the primary
care or acute care CNP is not setting specific but is based on patient care needs. Program may
prepare individuals across both the primary care and acute care CNP competencies. If programs
prepare graduates across both sets of roles, the graduate must be prepared with the consensus-based
competencies for both roles and must successfully obtain certification in both the acute and the
primary care CNP roles. CNP certification in the acute care or primary care roles must match the
educational preparation for CNPs in these roles.
Consensus Report
The
Future of Nursing:
Leading Change,
Advancing Health
(IOM/RWJ)
tes
a
t
dS
e
t
i
n
Institute of Medicine
and
he Robert Wood Johnson Foundation
Donna E. Shalala
Committee Chair
RWJF Initiative on
the Future of Nursing
Issues
Recommendations
1.
2.
3.
4.
5.
6.
7.
8.
Key Messages
1. Nurses should practice to the full extent of
Outcomes
Increase the proportion of BSN prepared
nurses by 10% every two years to reach
80% by 2020.
Outcomes
Development and implementation of performance
measures to reflect the contributions of nurses and care
team to ensure better-quality care.
Nursing education and other graduate programs
integrate leadership theory and business practices across
the curriculum, including clinical practice.
A compilation of research on models of care and
innovative solutions, including technology, that will enable
nurses to contribute to improved health and health care.
Public, private, and governmental health care decision
makers should include representation from nursing on
committees and boards, on executive mgmt. teams, and
in other key leadership positions.
Use clinical outcomes data to drive emulation and
transparency among healthcare organizations
Goal #3 Collect
workforce data that is
consistent across states
Outcomes
Develops baseline dataset
Goal #4 - Foster an
environment that provides
consumers with access to
high-quality care that meets
their needs for affordability
Outcomes
Recruit Additional
stakeholders
Participation of legislators, staff,
administration officers in state coalition
events, meetings, briefings
Build relationships with stakeholders for
ongoing collaboration toward better
regulatory environment
Outcomes
RACs develop strategic plans to meet IOM
recommendations on education, leadership, data
collection and residencies based on characteristics of
the region
Quarterly reports submitted to Steering Committee in
advance of Steering Committee meetings
Health
The Commission
Advisory Inputs
Scientific advisors
Youth
commissioners
Papers
Consultations
Research
Commission
ers
Education of
Health
Professionals
for the 21st
Century
Global
Multiprofessional
Evidence-based
Instructioninstitution
34
Revolution in telecommunications
Expanding access to care in underserved
populations
Problems
Series of studies about education for
health professionals are about 100
years old
Contributions helped double life span
during the 20th century
Inequities exist in sharing advances
New health challenges emerged
environmental
new infections
behavioral and lifestyle risks
Millennium Development
Goals
1.
2.
3.
4.
5.
6.
7.
8.
MDG
10
year
s
later
Source:
UN Data
Status of MDGs
Disparities between rich and poor
countries make it difficult for poor
countries to achieve these goals.
Health goals are competing for money,
human capacity, and other resources.
Recommendation:
40
Milestones
Flexner,
Welch-Rose, and
Goldmark Reports
100 years of Florence Nightingale
Health Care Reform
WHOs renewed focus on primary
healthcare (PHC)
Millennium Development Goals
(MDGs) Dialogues
Problems
Mismatch of competencies of
professionals to needs
Professionals work in silos
Poor team work
Gender stratification and divide
Narrow specialization
Episodic care rather than continuous care
Hospital orientation rather than
community orientation
Weak leadership
Tribalism of
Professions
Issues
Number of medical schools does not match
with the number of medical graduates
Number of medical and nursing-midwifery
graduates does not equal the number of
employed doctors, nurses and midwives.
Explanations:
Brighter
Knowledge broker
Care-giver
Technology
Quality
Team leader
Advancing Health
Monopoly knowledge
Financial self-interests
Professional chauvinism
Over-specialization
Urban preference
Inequities in Health
2000+
Institutio Instructi
Institutio
Instructi
nal
onal
nal
onal
1900
46
Scientific
Scientific
Curriculum
Curriculum
University
University
Based
Based
ProblemProblemBased
Based
Learning
Learning
Academic
Academic
Centers
Centers
CompetencyCompetencyDriven
Driven
Local-Global
Local-Global
HealthHealthEducation
Education
Systems
Systems
Levels of Learning
Objectives
Outcomes
Informative
Information &
skills
Experts
Formative
Socialization &
values
Professionals
Transformative
Leadership
attributes
Change Agents
Competency-based education
Traditional Model
Curriculum
Educational
Objectives
Assessment
Competencies
Outcomes
Assessment
Curriculum
Seeds of innovation
Vision
Transforma
tive
Learning
Interdepend
ence in
Education
Health Equity
Individual
PatientCentered
Population
-Based
50
Systems Framework
Supply of health
workforce
Provision
Labor
market for
health
professional
s
Education
System
Provision
Health
System
Demand
Demand
Needs
Needs
Population
51
Challenges: 4 Cs
52
Recommendations
Reform
Instructional
Competency-driven
Action
Mobilize leadership
Local-Global
Inter + transprofessional
IT empowered
Educ resources
Enhance investments
New professionalism
Align accreditation
Institutional
Joint planning
Academic systems
Networking
Culture critical
inquiry
53
Fortify global
learning
Outcome
Professional
education for
health equity
Recommendations
Mobilize
Enhance
Align
Leadership
Investments
Accreditation
Fortify
Global Learning
Mobilize Leadership
Recommendations
Mobilize
Leadership
Enhance
Align
Investments
Accreditation
Fortify
Global Learning
Enhance Investments
Recommendations
Mobilize
Enhance
Align
Fortify
Leadership
Investments
Accreditation
Global Learning
Align Accreditation
National accreditation
develop criteria for assessment
define metrics of output
shape the competencies of graduates
Global cooperation
be promoted by WHO, UNESCO, ICN, and others
set standards that can function as global public goods
assist countries in developing the capacity for local
adaptation and implementation
facilitate information exchange
promote shared responsibilities for accreditation
Recommendations
Mobilize
Enhance
Align
Leadership
Investments
Accreditation
Fortify
Global Learning
Recommendations
Reform
Instructional
Competency-driven
Action
Mobilize leadership
Local-Global
Inter + transprofessional
IT empowered
Educ resources
Enhance investments
New professionalism
Align accreditation
Institutional
Joint planning
Academic systems
Networking
Culture critical
inquiry
62
Fortify global
learning
Outcome
Professional
education for
health equity
Process
Institutional Design
Financing
Stewardship
Accreditation
Collaborations
Metrics
Instructional Design
Context
Global-Local
Criteria admission
Competencies
Channels
Career pathways
Outcomes
Interdependence
in Education
Transformative
Learning
An Action Plan
Areas of Innovations in Interprofessional
Education
Curricular Innovations
Pedagogic Innovations
Cultural Elements
Human Resources for Health
Metrics (IOM 2012)
DRIVING
FORCES
Outcomes
RESTRAINING
FORCES
POPULATIONS
Lack of Expertise
ORGANIZATIO
NS
Interprofessio
nal practice,
education,
research
Cultural Silos
STRUCTURES
Reimbursement
POLICY
(Young, Siegel, McCormick, Fulmer, et al, 2011)
Innovations
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Lancet Editorial
(Social Accountability in Health Professionals Training; L.S. Wen,
S. R. Greysen, D. Keszthelyi, J. Bracero, P.D. G deRoos)
COLLABORATION
PARTNERSHIP
TEAMWORK
At the crux of
creating safe
and quality
healthcare are
teams,
partnerships,
and
collaborations
What is Needed:
Collective concern
for global healthcare
and role of nurses in
providing
quality
care
We Nee
d to Pre
pare
a Gene
ration o
f
Gradua
tes
Wh o W
i l l H av e
a Voice
an d W h
o Use T
heir Vo
to Make
i
ce
a Differ
ence
in the W
ell-bein
g of
Populat
ions
Gracias