The Osteopathic Council of New Zealand is implementing an eportfolio process across a range of work based competence procesesses

1. Stiofán Mac Suibhne

2.  NZ Regulatory Framework
 Statutory Duties
 Work-basedAssessment - e-Portfolio / PebblePad
 Implementation

3.  Legacy of the ‘Unfortunate Experiment’
 Health & Disability Commission
 Strong regulatory presence – Common Law right to litigate
removed
 No blame compensation / rehabilitation regime
 Health Practitioner Competence Assurance Act (2003)
 Osteopathy is one of 17 healthcare professions subject to
statutory regulation
 Treaty obligations / biculturalism

4. (1)The principal purpose of this Act is to
protect the health and safety of members
of the public by providing for mechanisms to
ensure that health practitioners are
competent and fit to practise their
professions.

5.  Determine scopes of practice
 Prescribe qualifications / accredit institutions
 DetermineCompetency Frameworks
 Operate systems that ensure ongoing
maintenance of competence
 Assess international osteopathic graduates
 Competence reviews
 Fitness to practice reviews
 Professional conduct

6.  Workbased competence programmes
 Return to practice
 Overseas assessment
 Scope of Practice development
 Advanced practice
 Upskilling
 Grandparenting

8. Reflective practice: ‘the capacity to reflect
on action so as to engage in a process of
continuous learning’ (Donald Schön 1930 –
1997).
One of the defining characteristics of
professional practice.

9. An understanding of the nature of ‘Practice’ is central to
designing an assessment process which is capable of
capturing evidence of an individual’s ability to practice.
 The first step in designing the assessment process was
accepting a conceptual model for osteopathic
practice.
 Then developing an analysis / deconstruction of practice
from the perspective of process - rather focussed on
academic knowledge – Osteopathic Capabilities
Framework.
 Identifying assessment tools to assess the various
components of practice. K S A

10.  A form of assessment that aligns learning and
assessment was required allowing the practitioner to
identify and develop a reflective approach.
 Defensible mechanism that allows evidence to be
assembled and, notwithstanding the diversity of
approaches to practice, allows competencies to be
identified within a flexible capabilities framework.
 Creating an understanding of reflective practice and a
commitment to lifelong/lifewide learning - training
and dialogue with the profession.

11.  Three year cycle of regional conferences to raise awareness
amongst the profession.
 Problematising current approaches and sharing an understanding
of the theoretical framework supporting the use of PebblePad
 Migrating from a p-portfolio to an e-portfolio:
 Encouraging practitioners to creatively develop and use
PebblePad as a personal learning space.
 Creating allies and project champions. Identifying potential pilot
sites for trialling professional development/recertification
processes.

14. Interprofessional
Relationships
Primary
Healthcare
Responsibilities
Osteopathic
Care &Scope of
Practice
Person
OrientatedCare
& Commuication
Professional &
Business
Activities
ClinicalAnalysis

15. Descriptor
This capability incorporates an osteopath’s ability to
gather information about a patient’s health from a bio-
psychosocial perspective. This should inform examination
and screening, diagnosis, prognosis, condition and health
management from a patient-oriented context. This
diagnosis and care plan should reflect the complex bio-
psychosocial nature of the presentation and include
ongoing review. It incorporates an understanding of
clinical complexity and uncertainties and the professional
commitment to manage these components within patient
care

16. 1.1 gathers organises and records a focused personal health record
1.2 synthesizes information into a suitable working diagnosis and
an understanding of general health status
1.3 devises and instigates a plan of care addressing the person’s
presenting disorder and their general health, in consultation
with that person (or their representative or carer)
1.4 establishes a prognosis, appropriate outcome measures,
reviews patient progress and modifies plan of care as required
1.5 recognises when further information is required
1.6 critically reflects on clinical challenges and uncertainties

17. 1.1.1 critically uses a variety of information
retrieval mechanisms, including osteopathic
physical examination and palpation techniques
1.1.2 Compiles a health care record that is personal
to the individual
1.1.3 Incorporates bio-psychosocial components
within the health record
1.1.4 Ensures patient-centred orientation of case
analysis

18.  Conventional wisdom of evidence based practice applies
theoretical knowledge to practice.
 In reflective practice theory and practice are seen as
being reciprocally inter-related.
 Professional identity / knowledge is complex and is not
merely assembled from discreet knowledge base.
 Professional knowledge / identity arises from a
synthesis of natural and social sciences

20. Reflection-in-Action: as we work identifying learning
needs / opportunities
Reflection-on-Action: After the fact seeking theoretical
perspectives and integrating them into our thinking
Reflection-for Action:Applying knowledge to practice
Creating Personal reflective space / Organisational
Context. Thinking>Analysis>Self>Awareness

22.  OCNZ needs to be realistic
 Broad church
 Freshen up - maintain interest in practise
 Skills acquisition: Cognitive - Associative - Autonomous
- "OK" Plateau - Fitts& Posner
 Honesty & Openness to change / development

23.  Miller’s pyramid of competence indicates that assessment of ‘does’
reflects professional authenticity.
 Whatever one ‘does’ in the assessment must reflect practice in order for
that assessment to be authentic.
 The portfolio’s purpose is to guide learning and capture evidence
 Portfolio was the Hoorah word of ‘90s
 Evidenced Based Practice ’oos
 e-Portfolio is current Hoorah!
 Trial the e-Portfolio for the overseas assessment processes
 Reference Group to look at applications for CPD / Recertification
Processes

24.  Learning NeedsAnalysis
 Personal Development Plan
 Learning Outcome Reports
 Case based Discussion
 Critical Incident Report
 Critiquing journal articles
 Literature reviews
 Reflective statements from training courses

25.  Scope of Practice Reform 2007 - 12
 Osteopathic Capabilities Framework 2007-09
 Development of work-based competence assessment
2010
 PebblePad PreceptorTraining Nov 2013
 Unitec – Clinical Practicum 2013
 Trialled for overseas assessment 2013
 Overseas Assessment Process from Jan 2014
 Peer GroupTraining August 2014
 Recertification -Voluntary adoption by registrants 2015
 Recertification Mandatory 2016

26.  Resource constraints
 Conventional thinking amongst administrative staff.
 Focus on the added value of reflection on practice over the
growing pains of different working practices.
 Reluctance of osteopaths to be assessed.
 Osteopathic Exceptionalism - the ultra-positivists & the insider /
outsider problem.
 An advantage of the slow burn approach with the profession has
been time for the conceptual framework to be understood and
producing practitioners that are keen to push forward with
innovation.

28. Move the focus of what the profession
understands constitutes competence beyond
the boundaries and artificial subject areas of
traditional pre-registration training courses
to professional practice.
Progress not perfection