Guidance for Work Based Training for Assistant Practitioners

Guidance for Competency Training for Skill Sharing

The Calderdale Framework1 training stage (stage 6) comprises 3 parts leading to the development of competent practice. This training methodology has been accredited by Yorkshire and the Humber SHA Clinical Skills Network2 as best practice. Registered Practitioners undertaking the skill sharing competency training need to identify an occupationally competent colleague to act as their mentor/supervisor for this training.

Calderdale Framework Training 3 Part Training Methodology

The CF training method comprises 3 elements: taught, modelled (simulated) and competent in practice. These elements must be undertaken for each competence, and for the Modelled and Competent step it is necessary to develop and show competence in variations of the overall competency

Taught Element

The taught element is provides trainees with the background information and knowledge required to undertake the competency. The University of Bradford also provided bespoke one day training as an introduction which focused on clinical reasoning and professional philosophies/models. There is also an expectation that registered practitioners will undertake additional CPD relating to skill sharing to widen and deepen their knowledge, in conjunction with the competency training.

The registered Practitioners learn and discuss elements of assessment and explore clinical reasoning considerations and indications for assessment & treatment along with indications for when to seek advice. This session builds on the knowledge and experience of each attendee, and utilises case studies.

There is no formal testing at the end of this session, however it forms the basis on which to develop competence in a simulated setting (the Modelled element).

Signing of the Taught element will only be done by the occupationally competent trainer when:

i) the whole session has been attended

ii) the registered practitioner has actively taken part and demonstrated their understanding of the competency.

iii) The registered practitioner has shown an understanding of the responsibility & accountability of their role.

Modelled (Simulated) Element

The modelled element allows the registered practitioner to assimilate knowledge and apply it in their specific setting and develop their clinical reasoning and clinical skills in a safe, supported way3. The occupationally competent mentor/clinical supervisor has an important role in supporting the development of the trainee at this stage.

This is done in a graduated way:

i) Using case studies (devised by the mentor/clinical supervisor) to explore and develop clinical reasoning.

ii) Through observation of a skilled practitioner undertaking the task followed by discussion and explanation of the reasoning and actions as a result.

iii) Moving this to joint assessment with a skilled practitioner and the trainee sharing their clinical reasoning

It is important that the modelled phase encompasses the range of solutions in each competency as well as the range of service users likely to be seen in the service. The clinical reasoning records should be used as the basis for teaching and learning and registered practitioners should be encouraged to keep copies in their CPD file with reflective accounts.

The length of the modelled element will vary depending on the clinical service, and the previous experience and training of the registered practitioner.

It is crucial that the clinical supervisor ensure they are available for sessions with their trainee, and that sessions are booked regularly in order to maximise learning opportunities.

Competent Element

This element is a natural progression from the previous stage. At this stage the registered practitioner would be undertaking skill sharing with patients. It is expected that the registered practitioner would discuss their assessment and reasoning with an occupationally competent colleague and in clinical supervision. Once both the registered practitioner feels confident and competent to undertake the task/function and their occupationally competent mentor/supervisor agrees they are ready they would be observed and assessed against the competency criteria.

If all criteria are met the registered practitioner would be signed off as competent for that task/function.

It is important that the competency element of training encompasses the range of service users likely to be seen as well as the range of solutions covered in the competency i.e. the registered practitioner may need to demonstrate competence on a range of patients and with the required range of solutions. Assessment of competence must be carried out by an occupationally competent practitioner – therefore this will not always be the mentor. It is important that the mentor liaises with relevant assessors to discuss progress/issues.

On going clinical supervision, reflective practice and maintenance of a CPD portfolio together ensure competence is retained and further developed.

References

Smith R, Duffy J ‘Developing a Competent and flexible workforce using The Calderdale Framework’ 2010 International Journal of Therapy and Rehabilitation, 17(5): 254 - 262

2. Yorkshire and The Humber Clinical Skills Executive

[accessed 2.11.2012]

R Aggarwath, OT Mytton et al ‘Training and simulation for patient safety’ Qual Saf Health Care 2010;19(Suppl 2):i34ei43.

[accessed 13.11.12]