The successful completion of practice placements is essential to the education
of occupational therapists; however, ensuring quality placements is challenging
for occupational therapy educators. In 2000, Brunel University introduced a
revised system of accreditation of practice educators which involved attendance
at a course, the supervision of a student and the submission of an essay to be
assessed.
An audit revealed that a total of 314 therapists attended 15 courses between
2000 and 2003; of these, 243 (77%) subsequently supervised students and
32 (10%) became accredited. The requirement to accredit practice educators,
which is a commendable attempt to ensure quality, may paradoxically have
been detrimental in achieving quality. The College of Occupational Therapists’
apparent change of emphasis on this topic is welcome

Craik, C

Gallagher, M

McIntyre, A

British Journal of Occupational Therapy

English

 The successful completion of practice placements is essential to the education of occupational therapists; however, ensuring quality placements is challenging for occupational therapy educators. In 2000, Brunel University introduced a revised system of accreditation of practice educators which involved attendance at a course, the supervision of a student and the submission of an essay to be assessed.  An audit revealed that a total of 314 therapists attended 15 courses between 2000 and 2003; of these, 243 (77%) subsequently supervised students and 32 (10%) became accredited. The requirement to accredit practice educators, which is a commendable attempt to ensure quality, may paradoxically have been detrimental in achieving quality. The College of Occupational Therapists' apparent change of emphasis on this topic is welcomed. </jats:p

Christine Craik

Anne McIntyre

Margaret Gallagher

Crossref

Accreditation of Practice Educators: An Expectation Too Far?

Brunel University Research Archive

404 British Journal of Occupational Therapy September 2004 67(9)Introduction Practice placements are a central aspect of the education of occupational therapists: the World Federation ofOccupational Therapists confirmed their importance in itsrevised guidelines (WFOT 2002) and the Quality AssuranceAgency for Higher Education emphasised the qualityassurance of placements in its revised system of majorreview of health care programmes (QAA 2004). The College of Occupational Therapists (COT 1993), asa stakeholder in assuring the quality of practice placements,introduced a system of accreditation of practice educators,with the responsibility for accreditation resting with thehigher education institution. However, the COT (2000) alsoemphasised the responsibility of individual occupationaltherapists to participate in the education of occupationaltherapy students, especially on placement, and to ‘undertakeand maintain accreditation through programmes of studyprovided by higher education institutions validated to deliverpre-registration education’ (COT 2000, section 5.5.1). The COT defined accreditation as ‘a formal process bywhich the education centre recognises good practice’ (COT 1994, section 7.1). There has been debate on whetherit is preferable to accredit the placement or the educator(Alsop and Crowder 2002). The COT (2003a) revised itsStandards for Education, describing this as a change inprocedure and not in policy. The revised standards do not refer to accreditation but to higher education institutionspreparing, developing and supporting practice educators.There has been no statement from the COT retracting itsposition on accreditation, but it appears to have changed itsemphasis on the issue. Brunel University has a long history of providing courses for practice educators and has changed the formatfrom time to time in response to educational philosophy, the preferences of occupational therapy services andindividual therapists. From 1998, in response to demand,the format has been a 3-day, profession-specific, non-assessed course available to occupational therapistsproviding, or planning to provide, placements for BrunelUniversity students. In redesigning the BSc(Hons) Occupational Therapydegree in 2000, a revised scheme of accreditation forpractice educators was introduced both to ensure andconfirm the quality of existing educators and placementsand to encourage the recruitment of new educators andplacements including non-traditional placements. Thecourse was redesigned to 3 days together with a one-dayfollow-up after the participants had supervised a student.This scheme of accreditation was for a period of 5 years andwas to be maintained by individual practice educators andoccupational therapy services taking a minimum of oneBrunel University student per academic year.Formal recognition of the revised course was sought andobtained from the COT and also from Brunel University,who approved the course at 10 credits at level 3 to beawarded to practice educators who completed theassessment successfully. The course formed part of theBrunel University continuing professional developmentportfolio and was promoted through the network of practiceeducators and coordinators.Routes to accreditationThree routes to accreditation were introduced.Practice EvaluationThe successful completion of practice placements is essential to the educationof occupational therapists; however, ensuring quality placements is challengingfor occupational therapy educators. In 2000, Brunel University introduced arevised system of accreditation of practice educators which involved attendanceat a course, the supervision of a student and the submission of an essay to beassessed. An audit revealed that a total of 314 therapists attended 15 courses between2000 and 2003; of these, 243 (77%) subsequently supervised students and 32 (10%) became accredited. The requirement to accredit practice educators,which is a commendable attempt to ensure quality, may paradoxically havebeen detrimental in achieving quality. The College of Occupational Therapists’apparent change of emphasis on this topic is welcomed.Accreditation of Practice Educators:An Expectation Too Far?Christine Craik, Anne McIntyre and Margaret Gallagher405British Journal of Occupational Therapy September 2004 67(9)Novice practice educators This route involved attendance at a practice educator course;supervision of a student within 6 months of attending thecourse; the successful submission of an assessed reflective essay;and annual attendance at a practice educator briefing/study day.Experienced practice educators This route was designed for senior therapists who hadpreviously attended a course. It involved having supervisedat least two Brunel University students; the submission of atestimonial from a supervisor, mentor or line manager; thesuccessful submission of an assessed reflective essay; andannual attendance at a practice educator briefing/study day. Experienced practice coordinatorsThis route was designed for senior therapists whocontributed to practice education but might not directlysupervise students and may not have attended a recenteducator course. It involved 5 or more years’ experience ofstudent education including direct supervision; theorganisation of practice education in a service or anequivalent responsibility; the submission of a testimonialfrom a mentor, line manager or colleague; the successfulsubmission of an assessed reflective essay; and annualattendance at a practice educator briefing/study day.Aim of the audit In 2004, it was decided to evaluate the accreditation systemover the previous 3 years to see if it had met its aims ofincreasing the number of practice educators and placementsand ensuring their quality. This was especially relevant inview of the COT’s (2003a) revised standards, which nolonger specified accreditation.MethodAn audit was undertaken of the number of occupationaltherapists becoming accredited through the three routes,including an analysis of the therapists attending the practiceeducator courses during the academic years 2000/1, 2001/2and 2002/3. This consisted of noting the number who hadattended each course, tracking those who subsequentlysupervised a student and, finally, noting the number whosuccessfully achieved accreditation. Descriptive statisticswere used to analyse the data.Ethical considerations were taken into account inconducting the audit and the anonymity of the practiceeducators attending the courses was preserved. The actualdates of the courses have not been presented to reduce thepossibility of the practice educators recognising the coursethat they, and others, had attended. Results Novice practice educatorsA total of 314 occupational therapists attended 15 coursesbetween 2000/1 and 2002/3. Of these, 243/314 (77%)supervised students, ranging from 13/23 (57%) of course 5 in2001/2 to 25/26 (96%) of course 3 in 2000/1. The numberobtaining accreditation through successful submission of the2000-word reflective essay was 32/314 (10%), ranging fromnone on 3 courses to 5/18 (28%) on course 1 in 2000/1. Overall, the numbers attending the courses increasedand the percentage supervising students remained fairlyconstant, but the number becoming accredited diminished.The results for all 3 years are displayed in Table 1. Table 1. Results of audit for all 3 years Course date No. No. % No. %attending supervising accredited2000/11 ..............................18....................15............83..............5...........28 ...2 ..............................14....................10............71..............2...........14 ...3 ..............................26....................25............96..............4...........15 ...4 ..............................12....................10............83..............1.............8 ...5 ..............................22....................15............68..............3...........14 ...Total......................92 ..................75...........82...........15 .........16...2001/21 ..............................20....................17............85..............0.............0 ...2 ..............................18....................17............94..............2...........11 ...3 ..............................27....................20............74..............0.............0 ...4 ..............................24....................14............58..............2.............8 ...5 ..............................23....................13............57..............0.............0 ...Total....................112..................81...........72.............4 ...........4...2002/31 ..............................27....................22............81..............3...........11 ...2 ..............................25....................21............84..............3...........12 ...3 ..............................20....................18............90..............3...........15 ...4 ..............................13......................9 ............69..............2...........15 ...5 ..............................25....................17............68..............2.............8 ...Total....................110..................87...........79...........13 .........12...Grand total .........314................243...........77...........32 .........10...Experienced practice educators and experienced practice coordinatorsThe audit revealed that no experienced practice educator orexperienced practice coordinator applied to becomeaccredited during the period studied.Discussion First, it was disappointing that none of the experiencedpractice educators or coordinators had chosen to becomeaccredited because the system was introduced followingconsultation with colleagues. Creating the opportunity foraccreditation may have been a worthy aspiration, but theseexperienced therapists appeared to have judged that theeffort of accreditation outweighed any advantage for them.Although the accreditation system was explained andpromoted when first introduced, it may have requiredcontinuing promotion to experienced therapists. 406 British Journal of Occupational Therapy September 2004 67(9)For novice practice educators, the aim of encouragingmore occupational therapists to become educators and offerplacements appears to have been successful, with 243 (77%)therapists supervising students. There is usually a time intervalbetween completing a course and supervising a student, sothere is still opportunity for therapists on the more recentcourses to take a student and, therefore, fulfil one of thecriteria for accreditation. However, it seems unlikely thattherapists who attended a course more than 3 years ago willnow offer to take a Brunel University student. They mayhave supervised a student from another university, and thecourse encourages this national perspective, but the presentsystem has no way of capturing that information; if so, theaccreditation process has been successful. Although a principal aim of a university providing coursesis to educate therapists who will supervise their students,different courses will cover similar elements and universitiesrecognise courses provided by other higher educationinstitutions. Some therapists may attend a course and thendecide not to take a student, but it would seem unexpectedthat 23% would do so. A more likely explanation is the mobilityof therapists working in the London area, where highvacancy rates are common and result in frequent job moves.The aim of ensuring and confirming the quality ofexisting placements through the Brunel University scheme of accreditation has not been met, with only 10% of the 314 therapists becoming accredited. The interval betweenattending a course and accreditation may take many monthsbecause of the submission and marking of the reflective essayfollowing the student placement. It is probable, therefore, thatsome therapists who attended the later courses will eventuallybecome accredited and that the 4% and 12% achieved in themore recent years may improve to the 16% of the first year.Even so, this appears to be a disappointing result. Nevertheless, over the 3 years of the study, 211/314(67%) therapists completed the course and supervised astudent, although they chose not to continue with theacademic component of the accreditation process. Judgedthis way, the results seem more positive and these therapistsare clearly fulfilling the expectations of the COT (2000) tocontribute to the education of students. Thus, the issueappears to be not with the course or the experience ofsupervising a student, but with the process of accreditation.An expectation too far?So was accreditation an expectation too far? That may dependon the definition of accreditation. If the COT definition was‘to undertake and maintain accreditation through programmesof study provided by higher education institutions’ (COT2000, 5.5.1), perhaps it was suggesting that attendance at acourse was the only requirement for accreditation. But thatnarrow definition would obviate the need to supervise astudent, which contradicts the overarching COT (2000)statement about professional responsibility to participate instudent education. Further, it precludes the need to provideany evidence of learning on the course, which is not inaccord with the spirit of evidence-based practice alsoespoused in the same document (COT 2000). There have been efforts to promote the education ofstudents and accreditation within a framework of continuingprofessional development (Fisher and Savin-Baden 2002,Craik 2003) and to encourage therapists to view accreditationas one means of providing evidence of continuingprofessional development. Both the COT (2003b) and theDepartment of Health (2003), through the NHS Knowledgeand Skills Framework and Related Developmental Review,endorse the concept of continuing professional developmentand providing evidence of its achievement. The HealthProfessions Council’s (2004) much heralded emphasis oncontinuing professional development as a means of ensuringcompetence to practise and maintaining registration has notyet been defined and is to be the object of a consultationprocess. Perhaps these initiatives will give impetus tocontinuing professional development and to accreditation asone method of achieving this.In the meantime, with the increasing demands onpractitioners, the expectation that they would be prepared tobecome accredited through the system at Brunel University,with the additional requirement to present an essay forassessment, may have been an expectation too far. Thus,accreditation could be viewed as a disincentive to therapistsbecoming involved in student education and the systemdesigned to ensure quality may paradoxically, therefore,have had the opposite effect. In questioning accreditation, there is no suggestion that ensuring the quality of practice education is notimportant. Indeed, the reverse is true and the QAA (2004),in revising its system of approving the quality of healthprofessions’ courses, has increased its emphasis on practiceplacements. But the system of accreditation devised atBrunel University and approved by the COT does not seemto have achieved this aim of ensuring quality. The COT alsoappears to have similar doubts about accreditation asindicated in its revised standards document (COT 2003a).Having introduced accreditation in 1993 and promulgatedits benefits in 2000, its apparent change of policy, inremoving any reference to accreditation in 2003, wasunexpected and an explanation would be welcome. Rather than speculate on the reasons that 211 therapistssupervised a student but chose not complete the processthat could have led to accreditation by Brunel University, it may have been possible to conduct a follow-up study.However, the requirements of the National Health ServiceResearch Governance make this a complex procedure and itdid not seem justified if it might alienate those therapistswho continue to offer placements but choose not tocomplete the accreditation process.ConclusionBrunel University can continue to offer its scheme ofaccreditation as an option for therapists who choose torecognise their interest and commitment to practice educationthrough this more academic route without those who do notchoose this option feeling guilty. Brunel University can407British Journal of Occupational Therapy September 2004 67(9)therefore continue to provide not only high quality practiceeducator courses that consistently receive excellentevaluations from participants but also support to educatorsfor their exciting and rewarding role of contributing to theeducation of the next generation of occupational therapists.In doing so, the COT (2003a, b) standards can be met andindividual therapists can contribute to their own continuingprofessional development. Nevertheless, the question remainsof how the profession designs a system that will support thequality of practice education for all the stakeholders and it isunderstood that the COT continues to consider this. Acknowledgements Thanks are accorded to the North Essex Education Consortium (formerly leadconsortium for occupational therapy education in London) who funded theAccreditation Project and to all Brunel University practice placement educatorswho have contributed and do contribute to the education of our students.References Alsop A, Crowder R (2002) Accreditation under debate. OccupationalTherapy News, 10(9), 26-27.College of Occupational Therapists (1993) Standards, Policies andProceedings 165. Statement on fieldwork education: guidelines forassuring the quality of the fieldwork education of occupationaltherapy students. London: COT.College of Occupational Therapists (1994) Standards, Policies andProceedings 166. Statement on fieldwork education: recommendedrequirements for the accreditation of fieldwork educators. London: COT.College of Occupational Therapists (2000) Code of ethics and professionalconduct for occupational therapists. London: COT.College of Occupational Therapists (2003a) College of OccupationalTherapists Standards for Education: pre-registration educationstandards. London: COT.College of Occupational Therapists (2003b) Professional standards foroccupational therapy practice. London: COT.Craik C (2003) Why are OTs still playing catch up: modernising fieldworkeducation. Therapy Weekly, 10 April, 6.Department of Health (2003) The NHS Knowledge and Skills Frameworkand Related Developmental Review. London: DH.Fisher A, Savin-Baden M (2002) Modernising fieldwork, part 1: realisingthe potential. British Journal of Occupational Therapy, 65(5), 229-36.Health Professions Council (2004) Consultations – continuing professionaldevelopment. Available at: http://www.hpc-uk.org/consultation/cpd.htmAccessed on 24.03.04.Quality Assurance Agency for Higher Education (2004) Major review ofhealth care programmes. Available at: http://www.qaa.ac.uk/health/health_handbook.htm Accessed on 26.03.04.World Federation of Occupational Therapists (2002) Revised minimumstandards for the education of occupational therapists. WFOT.AuthorsChristine Craik, MPhil, DMS, DipCOT, MCMI, ILTM, Director of OccupationalTherapy, Brunel University, Osterley Campus, Borough Road, Isleworth,Middlesex TW7 5DU. Email: christine.craik@brunel.ac.ukAnne McIntyre, MSc, DipCOT, PGCHE, Lecturer in Occupational Therapy,Brunel University, Osterley Campus, Borough Road, Isleworth,Middlesex TW7 5DU. Email: anne.mcintyre@brunel.ac.ukMargaret Gallagher, MA, DipCOT, ILTM, Continuing Professional DevelopmentCoordinator, Brunel University, Osterley Campus, Borough Road,Isleworth, Middlesex TW7 5DU. Email: margaret.gallagher@brunel.ac.uk

Accreditation under debate.

Consultations – continuing professional development.Available at: http://www.hpc-uk.org/consultation/cpd.htm Accessed on 24.03.04.

Modernising fieldwork, part 1: realising the potential.

Occupational Therapists

Occupational Therapists (2003a) College of Occupational Therapists Standards for Education: pre-registration education standards.

Occupational Therapists (2003b) Professional standards for occupational therapy practice.

Quality Assurance Agency for Higher Education (2004) Major review of health care programmes.Available at: http://www.qaa.ac.uk/health/ health_handbook.htmAccessed on 26.03.04.

Standards, Policies and Proceedings 165. Statement on fieldwork education: guidelines for assuring the quality of the fieldwork education of occupational therapy students.

Standards, Policies and Proceedings 166. Statement on fieldwork education: recommended requirements for the accreditation of fieldwork educators.

Why are OTs still playing catch up: modernising fieldwork education.

World Federation of Occupational Therapists

Accreditation of practice educators:  An expectation too far ?

Accreditation of practice educators: An expectation too far ?

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