June 2013 Update from the President's Desk

As we near the middle of this year one of the longer running projects the Board has been supporting is nearing completion. The Competency Based Standards (CBS) are being provided in final draft form to Branches, Panels and tertiary institutions for their comment and feedback. The CBS describe the performance benchmarks expected of an AIR Accredited Practitioner in Radiation Therapy or Radiography on the attainment of the professions Statement of Accreditation.

The CBS provides a framework for professional and community expectations. The Standards aim to integrate the skills, knowledge and understanding that underpin the professions of Radiation Therapy and Radiography with the unique attributes and attitudes of these disciplines. These Standards have several purposes:

  • To provide standards of practice for the accredited practitioner
  • To provide standards necessary to assess overseas applicants seeking a Statement of Accreditation
  • To assist tertiary institutions to develop undergraduate and graduate entry programs
  • To provide a statement on the current status of our profession in the community
  • To provide government bodies such as AEI-NOOSR and DEST with information regarding best practice in our professions
  • To provide a resource for the development of industrial awards
  • To provide a framework for higher levels of practice (and career structure)
  • To support registration and licensing issues
  • To provide a framework for resumption of practice
  • To provide a resource document for students entering the profession and practitioners who have had a long period of absence from the profession and employers.

It is not intended for the CBS to set a national curriculum for program development leading to awards in MRS. This document is instead a minimum specification of standards, incorporating academic, clinical and professional elements for use by tertiary institutions in their program design.

In 2010 Darcy and Associates were commissioned to conduct an intensive literature review of the CBS and report back to the AIR. This report was also made available to the Council of Regulating Authorities (CORA). Darcy and Associates compared the current standards of practice for medical radiation professionals in Australia, New Zealand, Canada and the United Kingdom, and also examined standards in use by other health professions within Australia. The Darcy and Associates Report maintained that the five standards appeared to be working well for the profession but left open the discussion of what competence was and the part it played in professional activities. The report suggested that by discussing competence as it related to the profession the structural foundation of the revised standards could be organised into domains of competence.

Whether or not a person's capability makes them competent in a particular job depends on them being able to meet the requirements of that job. Hence competence in a job is defined as “the ability to perform the tasks and roles required to the expected standard” (Eraut, 1998). The advantage of using Eraut’s definition is that it can be applied at any stage throughout a professional career. An accredited practitioner will have achieved a level of competence to enable them to accept the responsibilities of practising independently and be capable of performing the expected role in a sole practitioner situation. An accredited practitioner should autonomously perform wide ranging clinical roles. 

There is a further level of judgement and skill which has variously been described as extended practice or advanced practice where the practitioner has the opportunity to develop and demonstrate expertise within an area of specialisation.

The 2013 review of the standards has modified and expanded on the existing format. The updated competency standard format now comprises five levels: 

  • Domain
  • Standard
  • Element
  • Indicator
  • Cues.

The 2013 competency standards have been grouped together into domains of professional responsibility. The six domains are:

  1. Professional and Ethical Practice
  2. Communication, Teamwork and Autonomy
  3. Knowledge and Understanding
  4. Critical Thinking and Evaluation
  5. Service Delivery and Clinical Management
  6. Lifelong Learning.

It is important to note that the order in which the domains are presented do not indicate an order of importance. Competencies in this framework are focused primarily on the patient’s perspective and experience. The priority or importance placed on each category is as follows: 

  1. Top Quality Clinical Outcomes
  2. Top Quality Patient  Care, Safety and Experience
  3. Information and Communication with Patients
  4. Communication in a Multidisciplinary Environment
  5. Education and Training
  6. Research and Development.

The standards in each domain reflect the level of proficiency and professionalism expected of the graduate practitioner upon attainment of the AIR Statement of Accreditation. Each competency standard describes the particular professional activity to be assessed or demonstrated. The standards are the explicit requirements of the Radiation Therapist or Radiographer as they move into the clinical environment.

The standards are further broken down into elements. These describe the key components or responsibilities within the standard. They aim to integrate knowledge, skills, attitudes and other important attributes of professional performance in the work place. The standards and elements are expressed in active form. There will be overlap, and often a number of elements will be performed simultaneously.

Indicators describe the performance criteria associated with each element. They represent actions which should be evident in the daily clinical practice to ensure the standards are being met.

Cues are intended to aid with clarification of the indicators of performance. These may cover aspects such as context for assessment or required evidence of competency.

There will be periodic reviews of the CBS as the profession continues to evolve and change. This should become part of routine quality assurance to ensure that this professional document meets the requirements of the time. I look forward to hearing from the membership once the draft CBS is released for comment and urge you all to participate in any review a Branch may organise.

Jo Page
President
Australian Institute of Radiography