European Competence Profile Adventures on a road less travelled

nEUroBlend 3rd Curriculum Conference Helsinki march 2006 European Competence Profile - adventures on a road less travelled – Curriculum Conference #3, march 2006 Nicolai van der Woert, MSc E Paul van Keeken, MScN Neuro-Sensory department Radboud University Nijmegen Medical Centre

nEUroBlend 3rd Curriculum Conference Helsinki march 2006 From ECP to ELP Function Profile  Competence Profile  Learning Plan  Module description, learning paths  Blended Learning Plan EFPEuropean function profileTask oriented, gives clues about how to do the job ECPEuropean competence profileCompetence oriented, gives clues about roles, contexts, outcomes & products and their criteria, reflection ELPEuropean Learning PlanGives info about the philosophy of learning and teaching MDModule DescriptionsDescribes the content areas in relation to competences FLPFlexible Learning PathsAlternatives for an individual to acquire competences at a certain level BLPBlended Learning PlanDescribes alternatives for using different modes of learning EOEducational OrganisationAlternatives for institutes at different levels of maturity to implement ECP in learning and teaching PPTPlan for Professionalising TeachersTrain the trainer plan IMPImplementation planStrategies, do’s and don’ts for different contexts 

nEUroBlend 3rd Curriculum Conference Helsinki march 2006 How things fit together BLP ELP ECP EFP PPT FLP MD

nEUroBlend 3rd Curriculum Conference Helsinki march 2006 Choosing … terminology From EFP to ECP Terminology: competence and competency From task descriptions & competencies to performance & competences Elements of a competence description: the competence Grid 3 Domains – acute, rehab, palliative/long term neurocare Task areas from the EFP ABCD (care process, systematic approach) + E,F (profession/organisation) Roles: a choice Levels of nursing Benner (1984)   competence levels nEUroBlend (2005/6); cross references Competent, proficient, expert (not: specialist nurses in one disorder) Core Competences relation to task-areas and roles Core Competence descriptions: filling the grid

nEUroBlend 3rd Curriculum Conference Helsinki march 2006 Competences A competence describes behaviour needed to be successful in a professional context. Levels criteria, reflection Competence development requires the use of knowledge, skills and attitudes in an integrated way within an authentic learning environment Different every time  Context Meta-action Result/product action Knowledge Skills Attitudes roles Anticipate Plan care or treatment Reflection Justify actions Explain why Criteria for action Product criteria  standards & routines Evaluate

nEUroBlend 3rd Curriculum Conference Helsinki march 2006 The difference between competence and a competency In search of the best starting point for the core competences, we evaluated the UK and dutch sets, and took a closer look at the EFP. The EFP holds a set of competencies for each task area, also for the rree domains. These can be added to the competence Grids The UK profile holds a set of competencies, expressed in knowledge- skills-attitudes; not yet in assessible or reflectable performance criteria. Knowledge-skills and attitudes described can be added to the competence grids. The dutch set of core competences are the closest to what we mean by a core competence. So they were chosen as an starting point for filling out the competence grids;. We expect them to be able to function in a in a modified form. The dutch set has partly been written out in a similar format as the competence Grid. Expanding these and rewriting them is a good basis for filling the competence grids.

nEUroBlend 3rd Curriculum Conference Helsinki march 2006 competences Core Competence 6, in relation to role/domain/ctx Domains Acute-rehab-palliative/long term Roles Care provider Director Coach/mentor Designer/planner Professional Context Meaningfull / daily practice; Task Areas ABCD-systematic approach/care E,F-profession,organisation Actions What? In which way? Criteria for action How? How well? Products/results What? Criteria for products/results How? How well? supportive Competencies, knowledge skils attitudes Reflection Why? Why this? Why this way? Anticipating / looking forward Assessment Determining competence level Critical incidents Benner / dutch Competences, NOT certificates Domains: 1.Acute neuro care 2.Neuro rehab 3.Neuro palliative & long-term care Domains can overlap Patient can shift domains Care can shift domains Combinations are possible …. 

nEUroBlend 3rd Curriculum Conference Helsinki march 2006 The competence Grid

nEUroBlend 3rd Curriculum Conference Helsinki march Domains – acute, rehab, palliative/long term neurocare Neuro acute care Many patients with neurological deficits have to cope with the loss or reduction of one or more vital functions. Control of these functions is of vital interest. The inclusion and accompaniment of patients’ families and next of kin in stressful situations also falls under this area of care. Neurorehabilitation Another characteristic of neurological deficits is that they can be coupled with sensory-motor, cognitive (Banich 2004, Hickey 2003) and emotional disturbances. As a result many patients are struck in the depths of their existence, often having drastic restrictions in carrying out activities or participating in society. The objective of neurorehabilitation is for patients with a non-congenital brain injury (NAH) to learn or re-learn perception, communication, attitude, movement and functioning as normally as possible. Neurorehabilitation is implemented using a learning process, which emphasises a 24-hour multidisciplinary approach. Team objectives are: Relearning of functions and skills; Retainment of functions and skills in areas where recovery is not possible Application of newly learned or relearned functions and skills in new areas (for example, walking from the chair to the toilet is learned in the practice room and then applied at home); Prevention of complications. Neuropalliative care / long term neurocare Palliative care is the continual, active and integral care of the patient and their relatives by a multidisciplinary team from the moment that, medically speaking, no recovery is expected. The goal of neuropalliative care is to achieve the highest possible quality of life, both for the patient and for their relatives, whereby the patient is treated as equal and co-responsible. Palliative care answers physical, psychological, social and spiritual demands. If necessary, neuropalliative care extends itself to support the mourning process (WHO 1990, Guerro Douglas 1998, Voltz & Borasio 1997). Insert the references of WHO at the end of this document In the EFP - Describe the domains better and more complete,more in balance; - Expand for long term neurocare; - Describe why and how domains overlap; - Possible shift of a patiënt and shift of care through the domains Domains

nEUroBlend 3rd Curriculum Conference Helsinki march 2006 Task Areas Task area A: Establishment of care required Task Area B: Care Planning Task Area C: Implementation of care Task Area D: Evaluation of care Task Area E: Profession specific tasks Task Area F: Organisation specific tasks Systematic approach, care process -Some task areas (E, F, parts of A-B-C-D) are the same for all three domains (or with very little variation). -For the Care process (A to D), differences occur for the three domains. A to D together contain the systematic approach to nursing. -Supportive Competencies (EFP, UK), and sets of supportive knowledge/skills/attitudes are described; they are mostly task based and not performance based; they can help describe competences -In the competence grids document, the relevant tasks and required supporting competencies have been pasted, and are to be rewritten to performance descriptionsinthecompetence grid - In 1 task, more competencies come together; - In1 competence,more tasks can shape the performance - To do: fill out the competence grids for each domain.

nEUroBlend 3rd Curriculum Conference Helsinki march 2006 Choosing from 3 sets of roles: Dutch, Finnish, Benner Cross-tables for comparison Benner roles (based on a skills model criteria for action, care giver oriented, Designer/planner and coach are not recognisable ) Dutch roles (smallest number, covering all three domains, developed for a competency based approach, ‘cara provider, director and designer/planner are more easy to develop further into the three levels we have choosen.) Geriatric specialist nurse roles (Finland, EU project; apply for the expert level nurse only, care provider not recognisable) Conclusion: the Dutch set of roles is the best starting point to add to the competence descriptions for Neuroblend; with some adjustments they can be made usefull for an international context also. Specalist roles applicable for expert level? roles

nEUroBlend 3rd Curriculum Conference Helsinki march 2006 Levels A choice has been made to use the three levels competent, proficient and expert, based on the Benner taxonomy Benner - levelactionsawareness and perception planTraining implications Competent Proficient Expert Benner - levelReflectionMain task areasShift in competencies performanceassessment Competent Proficient Expert

nEUroBlend 3rd Curriculum Conference Helsinki march 2006 Core Competence matrix

nEUroBlend 3rd Curriculum Conference Helsinki march 2006 describing competences

nEUroBlend 3rd Curriculum Conference Helsinki march 2006

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