Programs to prepare allied health professionals are the latest in a progression of health-related programs to be assimilated into college and university life. Like their predecessors, preparation programs for physicians and nurses, allied health programs developed almost willy-nilly in the past 50 years, and only within the past decade have begun to be taken seriously by the nation's leading colleges and universities. In this study, new departments of allied health that have been established in 133 senior colleges and universities with two or more programs accredited by the Committee on Allied Health Education and Accreditation were surveyed. From a sample of 36 institutions, fully useable responses were received from 114 heads of allied health departments and 90 heads of other academic departments, such as education, English, psychology, chemistry, and biology. The study revealed that there are significant differences in responses from allied health department heads and other academic area department heads in terms of personal characteristics (age, academic rank, and gender), departmental activities (allied health department heads place more emphasis on administrative tasks), and departmental goals. The most powerful variables differentiating responses between the two classes of department heads were percent of faculty with doctoral degrees, size of departments, percent of students in departmental courses who are departmental majors, emphasis given to teaching service courses, and emphasis on administrative activities. In summary, allied health departments (in contrast to other departments) are small (about six FTE), under credentialed, insular, engaged principally with their own majors, and committed primarily to the professional preparation of their students for future careers. Allied health department heads typically are experienced professionals who were brought to the institution from the outside to serve an indefinite term, and who appear to be overly concerned with the nuts and bolts of departmental administration. The researcher concluded that extant departments of allied health are still predominantly professional rather than academic in outlook and standard practice. / Ed. D.

Die derzeit geführten Diskussionen zu pädagogischen Neuerungen für die Notfallsanitäter-Ausbildung in Deutschland finden auf der Grundlage aktueller bildungsstruktureller Rahmenbedingungen des Notfallsanitäter-Gesetzes einschließlich der Ausbildungs- und Prüfungsverordnung für Notfallsanitäter sowie vor dem Hintergrund berufspädagogischer, berufsfelddidaktischer und allgemeindidaktischer Ansätze statt. Es geht vor allem um die Einführung eines umfassenden Berufsbildungskonzeptes, wenn eine zukunftsfähige Notfallsanitäter-Ausbildung auf wissenschaftliche, gesellschaftliche, wirtschaftliche sowie kulturelle Herausforderungen vorbereiten will. Dieser Beitrag zielt darauf ab, bildungstheoretische Überlegungen einschließlich kritischer Dimensionen im Kontext der Handlungsschwerpunkte von Notfallsanitätern zur Überwindung einer auf ausschließlich berufliche Verwertbarkeit gerichtete Bildung für die Notfallsanitäter-Ausbildung aufzugreifen. Dazu wurde ein Bestimmungsversuch rettungsdienstlichen Handelns mit Ableitung einer bildungstheoretischen Notwendigkeit unternommen. Daher war es naheliegend, eine geisteswissenschaftliche Haltung einzunehmen und das Verstehen des Sachverhaltes in den Mittelpunkt zu rücken. Folglich wurde sich bei der Erkenntnisgewinnung auf eine hermeneutische Theoriearbeit mit theoretischem Argumentieren unter Einbezug der aktuellen, gesetzlichen Ausbildungsrahmen bezogen. Die Beschreibungen zeigen auf, dass die Besonderheiten rettungsdienstlichen Handelns und die gesellschaftlichen sowie bildungsstrukturellen Rahmenbedingungen einer bildungstheoretischen Sicht als Grundlage für die Notfallsanitäter-Ausbildung bedürfen. Der Beitrag diskutiert, wie sich ein Bildungsbegriff als Metaparadigma der Notfallsanitäter-Ausbildung darstellen könnte und welche Konsequenzen sich hieraus trotz nicht zu verachtender Hürden für die pädagogischen Handlungsfelder und die zukünftige Forschung in diesem Bereich ergeben. / The current discussions on educational innovations concerning paramedic training programmes in Germany take place in accordance with the present conditional framework for education of the paramedics act, including training and examination regulations for paramedical health care professionals. Furthermore, approaches to vocational education, subject- related didactics and general didactics are taken into account. The focus will mainly be on the introduction of a complex vocational training concept in order to meet the requirements of paramedic training that will prepare for scientific, social, economic and cultural challenges. This article aims at discussing considerations concerning education theory, including critical analysis, and putting it into the context of the professional field of the paramedical discipline. However, this paper will not be limited to aspects of education that are directly linked to practical usage – but it will rather go beyond it. For this reason, it has been tried to identify the professional field of the paramedics and – for it will be necessary – to deduce information that might serve the needs of education theory. It seemed therefore to be obvious to take the position within humanities, and to put emphasis on the understanding of the issue. Consequently, as far as gaining knowledge is concerned, hermeneutic theory work and theoretical reasoning were taken into account, also involving the current legal requirements for the training framework. Descriptions show that, when it comes to the specific nature of the professional field of the paramedical discipline, and the social and the conditional framework for education, there is, as far as paramedic training is concerned, a need for taking a perspective that is based on education theory. The article discusses how an educational concept could be represented as a meta-paradigm for the paramedic training, and which consequences will arise in this respect, despite considerable obstacles to the educational fields of action and any future research in this area.

Dissertation submitted in fulfilment of the requirements for the Degree of Master of Technology: Emergency Medical Care, Durban University of Technology, 2011. / South African Advanced Life Support (ALS) providers follow an autonomous practice model of care. This advanced role profile is characterized by clinical skill competence and autonomous decision making whilst demonstrating a high level of awareness of their own ethical attitudes, values and beliefs. It is through a professional commitment that ALS providers deliver an advanced evidence based practice that should be maintained constantly within a dynamic environment. Continuous Professional Development (CPD) is seen as an instrument for this. CPD should also serve as a means to acquire professional excellence and going beyond the boundaries of meeting the base level standard with the aim of providing the finest quality of care in the interest of patient safety. Purpose of the research The purpose of this research is to identify gaps in the professional development of out-of-hospital ALS providers trained in South Africa by assessing frequency of performance of ALS clinical skills, by determining perceived level of competence and predictors of confidence, and by sourcing information on attendance of CPD activities and training needs. vi Methodology This study used a quantitative non-experimental design. Data was attained from an e-mail based descriptive survey that was limited to a precise and concise questionnaire. The data from 140 (N) ALS providers was subjected to a descriptive statistical analysis using the PASW statistics version 18.0 to systematically show patterns and trends. Frequency distributions were generated to describe data categories. Bivariate analysis was conducted using Chi-square and Pearson correlation tests. Results Results indicated that ALS providers performed clinical skills infrequently. Of the total number of respondents 140 (N), the average ALS clinical skills performance was 6 (4.8%) daily. In the 2-6 times a week category 8 (6.4%) ALS clinical skills were performed. ALS clinical skills performance in the once a week category showed an average of 7 (5.6%) and the once a month category, an average of 17 (13.7%) ALS skills were performed. An average of 31 (25%) ALS skills were performed in the once in six months category whilst an average of 54 (43.5%) were performed in the greater than six months category. CPD activities that are appropriate to ensuring the maintenance of competence for these clinical skills were not adequately undertaken. Medical updates were mostly attended by ALS providers, 52 (42.9%) whilst CPD events that addressed clinical skills, was mostly limited vii to the ACLS course 42 (34.7%). The needs assessment for CPD showed that 56 (53%) of respondents expressed a need for paediatric and obstetric simulated skill sessions, whilst 43 (40.9%) requested clinical skills workshops and 39 (37.1%) expressed a need for clinical practice in theatre and coronary care units. Conclusions and recommendations This study shows that ALS clinical skill competence is maintained by frequent practice and appropriateness of CPD activities. The infrequent performance of ALS skills coupled with the lack of appropriate and diverse CPD activity attendance results in poor maintenance of competence. The loss of competence can be related to poor reported levels of confidence which consequently places patient safety at risk. To safeguard against medical error and ensure patient safety, it is strongly recommended that CPD audits be undertaken on all ALS providers for appropriate CPD compliance related to clinical skills performance. In addition to a clinical skills audit, it is recommended that a national clinical skills registry be established with the intention of facilitating clinical skill surveillance, to determine a notifiable, high risk skill set. To safeguard against knowledge and clinical skill attrition and loss of competence, the delivery of CPD activities should be assessed for effectiveness and appropriateness.

Submitted in fulfillment of the requirements for the Degree Masters of Health Sciences in Emergency Medical Care, Durban University of Technology, Durban, South Africa, 2016. / Clinical practicum remains an integral part of training and a vital component of the emergency medical care curriculum that takes place in a realistic and complex emergency care environment. Clinical practicum should provide students with the opportunity to combine cognitive, psychomotor and affective skills to develop competencies to prepare the qualifying practitioner for demands of pre-hospital emergency care in the real world. The aim of this study was to explore the multidimensional aspects of the clinical practicum experience of ALS paramedic students in the Western Cape through the lens of a qualitative research design. The study involved exploring the experience of paramedic students in the clinical practice placement. In addition, the views of paramedic graduates were also explored, to ascertain whether the placement experience adequately prepared them for practice. An analysis of the clinical practice documents utilised in the training of ALS paramedic students was conducted with particular reference to identify correlations with relevant literature. In addition, it was necessary to identify how clinical practice manifested itself, not only in what students and graduates express but also how it was coordinated and conveyed in a professional work related context, against the backdrop of the work integrated learning framework. Using a case study design, focus group interviews were conducted with final year EMC students from CPUT and CCA students from the Western Cape CEC. This was followed with one on one interview with paramedic graduates. Further to this, clinical practice documents were analysed to triangulate the data. This study revealed that the clinical practice learning objectives for paramedic students were not adequately achieved and paramedic graduates felt ill prepared for independent practice. These discrepancies were attributed to the complex issues both in theory and practice. The study provided a number of recommendations for improving the clinical training experience, such that paramedic graduates who enter the complex and challenging world of EMC are better prepared. / M

ENGLISH ABSTRACT: The setting for this study was the University of the Western Cape, Faculty of Community and Health Sciences, first year undergraduate students. All students who participated in the compulsory interprofessional programme were from the following disciplines: Occupational Therapy; Physiotherapy; Psychology; Social Work; Natural Medicine; Dietetics; Human Ecology; Sports Sciences and Nursing. The objectives of this study were to measure the attitudes and perceptions of first year students who participated in an undergraduate interprofessional programme. The attitudes and perceptions were further measured in relation to the specific lecturers involved, the age of the students, their gender, race, background as well their specific discipline. This was primarily a quantitative study incorporating two qualitative questions in which 657 students were issued with a questionnaire designed to determine their attitudes and perceptions towards interprofessional education. A sample size of 264 students resulted in 95% confidence intervals with a maximum precision of 5%. The questionnaire was adapted, with permission, from Cameron; Rennie; DiProspero; Langlois & Wagner (2009). MS Excel was used to capture the data and STATISTICA version 9 (StatSoft Inc. (2009) STATISTICA (data analysis software system), www.statsoft.com.) was used to analyze the data from the questionnaires. Descriptive statistics was used to describe the main features of the sample of this study and summary statistics was further used to summarize the findings of this study in order to communicate the bulk of the information as simple as possible. Two open-ended questions were included at the end of the questionnaire and this was used to triangulate the data. The Kruskal-Wallace test was used to measure the results, whereby a p-value of <0.05 indicated statistical significance. Of all the factors used to measure the attitudes and perceptions of students, the following three were significant: Gender; Race and Discipline. No other factors impact on the attitudes and perceptions of students towards interprofessional education. Student attitudes and perceptions towards interprofessional education were found to be very positive. The findings revealed that the most significant factor in the study was the lack of understanding of various disciplines participating in the programme and their understanding of the relevance of the teaching approach (interprofessional) as well as their specific role in the health care team. This clearly illustrated the need to recommend to the co-ordinating unit of the programme that this be defined more clearly for the students and specifically the Sports Sciences students. / AFRIKAANSE OPSOMMING: Die studie het plaasgevind by die Universiteit van die Wes-Kaap, in die Fakulteit van Gemeenskap en Gesondheidswetenskappe, met eerste jaar voorgraadse studente wat die verpligte interprofessionele program doen. Studente sluit in die volgende dissiplines: Arbeidsterapie; Fisioterapie, Sielkunde, Maatskaplike Werk, Natuurlike Medisyne, Dieetkunde, Menslike Ekologie, Sport en Verpleegkunde. Die doelwitte van hierdie studie was om die houdings en persepsies van die eerste jaar studente wat deelgeneem het in 'n voorgraadse interprofessionele program te meet. Houdings en persepsies was gemeet met betrekking tot die ouderdom geslag, ras,agtergrond sowel dissipline van spesifieke studente. Daar was ook gekyk of die betrokke dosente ń invloed het op studente se houdings en persepsies teenoor die program. Die studie was hoofsaaklik kwantitatiewe met n kwalitatiewe komponent. Vraelyse was uitgereik aan 657 studente om hul houdings en persepsies teenoor interprofessionele onderwys te bepaal. 'n Steekproefgrootte van 264 studente het in 95% vertrouensintervalle met 'n maksimum akkuraatheid van 5%. Die vraelys is aangepas, met toestemming, van Cameron, Rennie; DiProspero Langlois & Wagner (2009). MS Excel was gebruik om die data op te vang en Statistica weergawe 9 [StatSoft Inc (2009) STATISTICA (data-analise sagteware stelsel), www.statsoft.com] is gebruik om die data van die vraelyste te analiseer. Beskrywende statistiek is gebruik om te beskryf die belangrikste kenmerke van die steekproef van hierdie studie. Opsommingstatistiek is verder gebruik om op te som die bevindinge van hierdie studie met die doel om die grootste deel van die inligting so eenvoudig as moontlik te kommunikeer. Twee oop vrae is ingesluit aan die einde van die vraelys en dit is gebruik om die data te trianguleer. Die Kruskal-Wallace-toets is gebruik om die resultate, waar 'n p-waarde van <0,05 aangedui word statistiese betekenisvolheid te meet. Van al die faktore wat gebruik was om die houdings en persepsies van studente te meet, was die volgende drie beduidende: geslag, ras en dissipline. Geen ander faktore impakteer op die houdings en persepsies van studente in interprofessionele onderwys. Studente se houdings en persepsies teenoor interprofessionele onderwys was beduidend positief. Die studie het bevind dat daar ń algemene gebrek aan begrip is vir die relevansie van die program. Dit sluit in hoekom die verskillende dissiplines aan die program deelneem as ook wat hulle spesifieke rolle in die gesondheidsorg span is. Die aanbeveling is dus dat die koördinerings eenheid van die program die kursus meer duidelik sal moet definieer om so doende die studente se kennis in terme van relevansie van die interprofessionele program uit te brei met spesifiek verwysing na die Sport studente.

This interpretive study investigated the process of radical change for a collaborative team of investigators in an allied health school at the University of South Australia. Specifically, it investigated the process of developing and implementing a fully-integrated problem-based learning curriculum across the entire undergraduate curriculum for the School of Medical Radiation. The study examined the richness and complexity of the change process for this team of educators over a two year time period. The research builds on understandings of change derived from three main bodies of literature: the school-based educational change literature; the problem-based learning literature; and the organisational change literature. It interweaves knowledge gained from each of these areas to develop a new perspective from which to consider radical educational change in higher education. Much of the previous research into change ignores the participant experience, and particularly the emotional dimension of this experience. This study redresses that gap by exploring the human dimension of the change process. This study has provided an authentic and inclusive representation of participants' experience of radical educational change. It has shown that participants not only undergo considerable cognitive dissonance when implementing major change, they also undergo significant emotional dissonance. Thus, if we are to improve the outcomes of educational innovation, we need to develop change management practices that not only recognise but also support the emotional dimension of the change process.

This interpretive study investigated the process of radical change for a collaborative team of investigators in an allied health school at the University of South Australia. Specifically, it investigated the process of developing and implementing a fully-integrated problem-based learning curriculum across the entire undergraduate curriculum for the School of Medical Radiation. The study examined the richness and complexity of the change process for this team of educators over a two year time period. The research builds on understandings of change derived from three main bodies of literature: the school-based educational change literature; the problem-based learning literature; and the organisational change literature. It interweaves knowledge gained from each of these areas to develop a new perspective from which to consider radical educational change in higher education. Much of the previous research into change ignores the participant experience, and particularly the emotional dimension of this experience. This study redresses that gap by exploring the human dimension of the change process. This study has provided an authentic and inclusive representation of participants' experience of radical educational change. It has shown that participants not only undergo considerable cognitive dissonance when implementing major change, they also undergo significant emotional dissonance. Thus, if we are to improve the outcomes of educational innovation, we need to develop change management practices that not only recognise but also support the emotional dimension of the change process.

Die derzeit geführten Diskussionen zu pädagogischen Neuerungen für die Notfallsanitäter-Ausbildung in Deutschland finden auf der Grundlage aktueller bildungsstruktureller Rahmenbedingungen des Notfallsanitäter-Gesetzes einschließlich der Ausbildungs- und Prüfungsverordnung für Notfallsanitäter sowie vor dem Hintergrund berufspädagogischer, berufsfelddidaktischer und allgemeindidaktischer Ansätze statt. Es geht vor allem um die Einführung eines umfassenden Berufsbildungskonzeptes, wenn eine zukunftsfähige Notfallsanitäter-Ausbildung auf wissenschaftliche, gesellschaftliche, wirtschaftliche sowie kulturelle Herausforderungen vorbereiten will. Dieser Beitrag zielt darauf ab, bildungstheoretische Überlegungen einschließlich kritischer Dimensionen im Kontext der Handlungsschwerpunkte von Notfallsanitätern zur Überwindung einer auf ausschließlich berufliche Verwertbarkeit gerichtete Bildung für die Notfallsanitäter-Ausbildung aufzugreifen. Dazu wurde ein Bestimmungsversuch rettungsdienstlichen Handelns mit Ableitung einer bildungstheoretischen Notwendigkeit unternommen. Daher war es naheliegend, eine geisteswissenschaftliche Haltung einzunehmen und das Verstehen des Sachverhaltes in den Mittelpunkt zu rücken. Folglich wurde sich bei der Erkenntnisgewinnung auf eine hermeneutische Theoriearbeit mit theoretischem Argumentieren unter Einbezug der aktuellen, gesetzlichen Ausbildungsrahmen bezogen. Die Beschreibungen zeigen auf, dass die Besonderheiten rettungsdienstlichen Handelns und die gesellschaftlichen sowie bildungsstrukturellen Rahmenbedingungen einer bildungstheoretischen Sicht als Grundlage für die Notfallsanitäter-Ausbildung bedürfen. Der Beitrag diskutiert, wie sich ein Bildungsbegriff als Metaparadigma der Notfallsanitäter-Ausbildung darstellen könnte und welche Konsequenzen sich hieraus trotz nicht zu verachtender Hürden für die pädagogischen Handlungsfelder und die zukünftige Forschung in diesem Bereich ergeben.:Inhaltsverzeichnis 1 Einleitung 1 2 Bildungstheoretische Grundlagen 5 2.1 Der Bildungsbegriff: Funktion und Charakter 5 2.2 Die Gegensätzlichkeit formaler, materialer und prozessorientierter Bildung 7 2.3 Die Verschränkung der Bildungstheorien: Klafkis kategoriale Bildung 9 2.4 Die Erweiterung des Bildungsbegriffes um eine kritische Dimension 10 2.5 Der Bildungsbegriff im Kontext beruflicher Bildung 13 3 Auf dem Weg zu einer Didaktik des Rettungsdienstes 15 4 Bestimmungsversuche rettungsdienstlichen Handelns 19 5 Bildung in der Notfallsanitäter-Ausbildung – erste Einschätzungen 24 5.1 Notwendigkeit einer bildungstheoretischen Fundierung 24 5.2 Potenzialität einer bildungstheoretischen Perspektive 28 5.2.1 Makroebene 29 5.2.2 Mesoebene 30 5.2.3 Mikroebene 34 5.3 Grenzen einer bildungstheoretischen Fundierung 35 6 Zusammenfassung und Ausblick 38 Literaturverzeichnis 43 Anhang Selbständigkeitserklärung / The current discussions on educational innovations concerning paramedic training programmes in Germany take place in accordance with the present conditional framework for education of the paramedics act, including training and examination regulations for paramedical health care professionals. Furthermore, approaches to vocational education, subject- related didactics and general didactics are taken into account. The focus will mainly be on the introduction of a complex vocational training concept in order to meet the requirements of paramedic training that will prepare for scientific, social, economic and cultural challenges. This article aims at discussing considerations concerning education theory, including critical analysis, and putting it into the context of the professional field of the paramedical discipline. However, this paper will not be limited to aspects of education that are directly linked to practical usage – but it will rather go beyond it. For this reason, it has been tried to identify the professional field of the paramedics and – for it will be necessary – to deduce information that might serve the needs of education theory. It seemed therefore to be obvious to take the position within humanities, and to put emphasis on the understanding of the issue. Consequently, as far as gaining knowledge is concerned, hermeneutic theory work and theoretical reasoning were taken into account, also involving the current legal requirements for the training framework. Descriptions show that, when it comes to the specific nature of the professional field of the paramedical discipline, and the social and the conditional framework for education, there is, as far as paramedic training is concerned, a need for taking a perspective that is based on education theory. The article discusses how an educational concept could be represented as a meta-paradigm for the paramedic training, and which consequences will arise in this respect, despite considerable obstacles to the educational fields of action and any future research in this area.:Inhaltsverzeichnis 1 Einleitung 1 2 Bildungstheoretische Grundlagen 5 2.1 Der Bildungsbegriff: Funktion und Charakter 5 2.2 Die Gegensätzlichkeit formaler, materialer und prozessorientierter Bildung 7 2.3 Die Verschränkung der Bildungstheorien: Klafkis kategoriale Bildung 9 2.4 Die Erweiterung des Bildungsbegriffes um eine kritische Dimension 10 2.5 Der Bildungsbegriff im Kontext beruflicher Bildung 13 3 Auf dem Weg zu einer Didaktik des Rettungsdienstes 15 4 Bestimmungsversuche rettungsdienstlichen Handelns 19 5 Bildung in der Notfallsanitäter-Ausbildung – erste Einschätzungen 24 5.1 Notwendigkeit einer bildungstheoretischen Fundierung 24 5.2 Potenzialität einer bildungstheoretischen Perspektive 28 5.2.1 Makroebene 29 5.2.2 Mesoebene 30 5.2.3 Mikroebene 34 5.3 Grenzen einer bildungstheoretischen Fundierung 35 6 Zusammenfassung und Ausblick 38 Literaturverzeichnis 43 Anhang Selbständigkeitserklärung