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Core Competencies for Stroke

Please note that resources housed on the Heart and Stroke Foundation website have recently changed location. As a result, related links within the Core Competency Framework are in the process of being updated.  We apologize for any inconvenience to pilot participants and encourage you to use the additional suggested resources as necessary.

The Ontario Stroke Network (OSN) provides provincial leadership and planning for Ontario’s 11 Regional Stroke Networks (RSN) by measuring performance, partnering to achieve best practices and creating innovations for stroke prevention, care, recovery and integration.

There is Level A Evidence that stroke unit care reduces the likelihood of death and disability by as much as 30 per cent for men and women of any age with mild, moderate or severe stroke. One of the key components of Stroke Unit Care is that the core interprofessional team should consist of healthcare professional with stroke expertise. Furthermore, Quality Based Procedures for stroke recommend that interprofessional stroke teams across the continuum receive education and training to promote stroke expertise.

In alignment with these recommendations, one of the OSN’s provincial priorities identified the development of a minimum set of competencies for health care professionals working in stroke. An OSN working group, comprised of representatives from each of the OSN provincial groups has developed a provincial stroke competency framework. This work builds on initial work by the Heart and Stroke Foundation of Ontario to develop interdisciplinary learning objectives for stroke care.

Framework Rationale

The Ontario Stroke Network (OSN) provides provincial leadership and planning for Ontario’s 11 Regional Stroke Networks (RSN) by measuring performance, partnering to achieve best practices and creating innovations for stroke prevention, care, recovery and reintegration.

There is Level A Evidence that Stroke Unit care reduces the likelihood of death and disability by as much as 30% for men and women of any age with mild, moderate, or severe stroke. One of the key components of Stroke Unit Care is that the core interprofessional team should consist of healthcare professionals with stroke expertise1. Furthermore Quality- Based Procedures for Stroke recommend that interprofessional stroke teams across the continuum receive education and training to promote stroke expertise.2

In alignment with these recommendations, one of the Ontario Stroke Network’s (OSN) provincial priorities identified the development of a minimum core set of competencies for health care professionals working in stroke. An OSN working group, comprised of representatives from each of the OSN provincial groups has developed a provincial stroke competency framework. This work builds on initial work by Heart and Stroke Foundation of Ontario (HSFO) to develop interdisciplinary learning objectives for stroke care.

Purpose

To provide health care professionals working in stroke with a clear, comprehensive way to achieve the core competencies needed for evidence based stroke care.

To support a more user-friendly experience, an online version of the framework is in progress. This online version will be implemented as a pilot in Fall 2016 with a launch of the final framework expected April 2017.

Organizations may wish to utilize the content contained in the current framework, albeit preliminary, pre-piloted work. For example, the content could assist organizations in the training/orientation of staff in new or established stroke units and/or for those teams engaging in an accreditation process.

The final framework will support a baseline level of competency province wide.

Competency: The capability to apply or use a set of related knowledge, skills, and abilities required to successfully perform “critical work functions” or tasks in a defined work setting. Competencies often serve as the basis for skill standards that specify the level of knowledge, skills, and abilities* required for success in the workplace as well as potential measurement criteria for assessing competency attainment3.

How do I use the Provincial Interprofessional Stroke Core Competency Framework?

This is a self-evaluation tool. This framework is intended for continuing education purposes, and should be integrated as much as possible into other learning opportunities such as workplace performance appraisals and discipline specific quality programs.

  1. Start by using the self-rating scale (located in the “Getting Started with the Self-Rating Scale” tab) to reflect on each the 16 competencies and their respective learning objectives. Print off the Self-Rating scale PDF.
  2. Look at each of the 16 competencies individually. Read through the learning objectives for each considering each competency as a whole. In the start date column, enter the number that most closely reflects your knowledge/ skill / experience with respect to each of the 16 competencies. This should result in 16 ratings, one for each competency.
  3. Once you have identified the competencies that you will work on (those rated 1-6), it is suggested that you work towards accomplishment of these competencies over a one year period. IF YOU ARE PART OF OUR PILOT PROJECT SEPT – DEC 2016, YOU WILL FOLLOW THE 4 MONTH TIMEFRAME AND THE GUIDELINES INCLUDED IN THE PILOT USER GUIDE.
  4. It is suggested that you work on one competency at a time. Review the suggested resources to help you learn the content of the learning objectives for each competency. Once you have read and/or worked through the resources, ensure that you complete the relevant evaluation. In some cases, this evaluation activity is a quiz following the learning resource and for other learning objectives, you will be asked to provide a written example or reflection that is based on application to your current practice. Completion of the evaluation activities is important as this is how you will provide evidence of achievement. Note that some of the resources and evaluation methods are the same across competencies so by working through one competency, you may also have made some progress towards achieving another competency.
  5. To help you stay on track, document your new self-rating for the competencies you are working on at 6 months and at 12 months. Enter your completion date for each competency. IF YOU ARE PART OF OUR PILOT PROJECT SEPT – DEC 2016, YOU WILL FOLLOW THE 4 MONTH TIMEFRAME AND THE GUIDELINES INCLUDED IN THE PILOT USER GUIDE.

Contact Information

Michelle Donald (Co-Chair)
Michelle.Donald@sunnybrook.ca
(416) 480-6100 Ext 7426
Susan Bursey (2016/17 Co-Chair)
sbursey@hsnsudbury.ca
(705) 523-7100

Description

This framework consists of a core set of stroke competencies for six disciplines – Nursing, Occupational Therapy, Physical Therapy, Speech-Language Pathology, Social Work, and Recreation Therapy. It is intended to support professional development towards stroke expertise.

This framework is intended for use by health care providers who are new to stroke as well as those who are very experienced. The self-rating scale included allows each health care provider to identify areas for learning. As a result, it is expected that those experienced in stroke care will not be working through all the competencies, but rather those that he or she identifies as areas for development.

It is suggested that all competencies identified as learning needs are achieved within a one year period. Each discipline specific template identifies the same 16 competencies:

  1. Principles of Stroke Care
  2. Anatomy and Physiology of Stroke
  3. Cardiovascular Respiratory Effects
  4. Psychosocial Effects
  5. Communication
  6. Independence in Mobility and Prevention of Complications
  7. Routine Activities of Daily Living
  8. Instrumental Activities of Daily Living
  1. Cognitive, Perceptual and Behavioural Changes Post Stroke
  2. Nutrition
  3. Dysphagia
  4. Skin Care
  5. Sexuality
  6. Continence Management
  7. Primary/Secondary Stroke Prevention
  8. Transition Management
For each competency, there are a number of learning objectives, recommended learning resources/knowledge translation tools and suggested evaluation methods.
It is important that you start by self-rating your level of competency within each of the stroke core competency areas. This will help you to identify your specific educational needs.

You can start by printing off the PDF document.

Look at each of the 16 competencies individually. Read through the learning objectives for each considering each competency as a whole. In the start date column, enter the number that most closely reflects your knowledge/ skill / experience with respect to each of the 16 competencies. This should result in 16 ratings, one for each competency. Highlight the ones with the lowest scores and start with these. It is suggested that within a one year period, you aim to accomplish a “7” (competency achieved) rating for all 16 competencies.

IF YOU ARE PART OF OUR PILOT PROJECT SEPT – DEC 2016, YOU WILL FOLLOW THE 4 MONTH TIMEFRAME AND THE GUIDELINES INCLUDED IN THE PILOT USER GUIDE.

The provincial core competency working group welcomes each organization as a participating site in the four month pilot phase of the Provincial Interprofessional Stroke Core Competency Framework. The PDF guide in this section will provide information specific to the participants of the pilot. Contact information is also provided as part of this guide should you have further questions.
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