So what's going on here?
On the y axis is competency level and on the x axis, time. As education proceeds, competency level increases (I've drawn the progression as linear but it most likely proceeds in fits & starts). The most important point in time is graduation, after which a number of trajectories could be followed. For purposes of simplification I've only drawn three:
- With no opportunity to practice & put to use the knowledge, skills & attitudes developed in school, competency quickly drops.
- With a low level of or irregular exposure to opportunities, competency stays flat.
- With continued opportunities to practice, competency increases until the individual becomes proficient.
So what do we do then?
Well, the potential answers are worthy of an entirely different post, but a few quick thoughts:
- There may be ways to use technology, e.g. clinical simulations, to increase exposure & at least maintain competency levels.
- The reason exposure is limited may be due to the fact that their education is not really preparing providers for the reality of their profession; that what they're learning isn't what they'll be doing upon graduation. A task analysis and changes to curricula may be in order.
- Policies may not be in place that allow healthcare workers to fulfill the role for which they've been prepared. For example, nurses may be educated to initiate and manage ART but national policy may only allow doctors to do so.
2 comments:
Good description and thought. Makes perfect sense. So how do people's competencies stay up if they can't get a job after graduation that uses them? Personal development the answer but not everyone likes to do extra work. I couldn't find a job right out of school doing what I wanted, but I did it on the side, not making much money but enjoying it more than the full time job. This helped me increase my competency as opposed to it flat-lining or declining. Of course, my profession lent itself to sefl-study and improvement (unlike nursing). Thanks for sharing this!
Andy, thanks for sharing your thoughts. And actually, I'm one of those people whose competencies quickly eroded after graduation: I studied ecology as an undergraduate but quickly got swept up in the Internet/Web growth of the mid-90's and completely changed the course of my career. But in some sense, my education still has had a lasting impact. I tend to take a high-level systems approach to my work in technology and I can trace that back to learning about ecosystems and evolution, playing around with simulations, etc. So maybe it's the case that even if many competencies erode, some may stick around & provide long-term benefits.
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