Exploring the transition from student to clinician by the first cohort of locally trained occupational therapists in Ghana

Nkansah, Opoku Eric (2020-03)

Thesis (MOccTher)--Stellenbosch University, 2020.

Thesis

ENGLISH ABSTRACT: Background : The nature of a new clinician’s transition from student to clinician is a significant determinant of the ease or difficulty of the journey to professional competence. Transition into practice for the new graduate has been described as a complex experience characterised by periods of stress and anxiety. In Ghana, after several failed attempts to establish occupational therapy services, the Ministry of Health in collaboration with the University of Ghana started an undergraduate programme in Occupational Therapy in 2012 (the first of its kind in the West African sub-region) to educate occupational therapists locally. This exploration of the experiences of transition into practice for the first cohort of locally trained occupational therapists was important because they worked autonomously and in a self-directed manner in their first year of practice after graduation, in a country where occupational therapy had not been established. Aims and objectives: The aim was to explore the experiences of the first cohorts of locally trained occupational therapists during transition from being students to clinicians within the first year of their practice in Ghana. The objectives were to explore the challenges and facilitators of their transition, the coping strategies employed to effectively manage the challenges they encountered and their experiences of continued professional competence. Methodology: The research comprised of three stages; stage one was to develop a systematic scoping review protocol to explore the factors that affect new clinicians’ transitions into practice. In stage two, the scoping review was conducted to synthesize literature published in the last two decades on the transitions of new clinicians into practice. The focus was to determine the challenges and facilitators of new clinicians’ transitions from student to clinician and the evidence-based coping strategies that can be employed to ease the transition. Stage three was a phenomenological study aimed at exploring the transition from students to clinicians by the first cohort of occupational therapists in Ghana. Two in-depth interviews were done with each participant. Inductive content analysis was used to analyse the data into four overarching themes. Ethical approval was obtained from the Health Research Ethics Committee of Stellenbosch University prior to conducting this study. Results: In the scoping review, 562 studies were initially identified, relevant data was extracted from 24 studies that met the inclusion criteria and were analysed to form this review. Four overarching themes emerged namely: systems and structures, personal capacities, professional competence and mediating processes. Each theme revealed the barriers, facilitators and coping strategies of transition into practice among new health graduates. In the phenomenological study, four themes emerged: ‘Being “new” in a new profession’, ‘Introducing occupational therapy into a medical model health system’, ‘Personal and professional competence,’ and “The future is bright”. New graduates found continued professional competence activities essential for successful transition into practice. Conclusions and recommendations: New graduates needed assistance to translate knowledge into practice. New graduates lacked adequate supervision given the lack of practicing occupational therapists to fulfill supervisory roles. What was evident from the findings is that, well-organized collaboration between undergraduate university educators, leadership and management of health facilities, other health professionals and the new graduates can facilitate a successful transition into practice. Future research is needed to explore the transition of other cohorts of occupational therapy graduates to explore if they had similar experiences. This will allow for a more holistic understanding of students transition into practice to generate further suggestions to enrich occupational therapy education and practice in Ghana.

AFRIKAANSE OPSOMMING: Agtergrond : Die aard van 'n nuwe klinikus se oorgang van student na kliniese praktisyn is bepalend van die gemak of moeite waarmee die oorgang na ‘n professionele vaardigheidsvlak gemaak word. Die oorgang van student na klinikus vir die nuwe gegradueerde word beskryf as 'n komplekse ervaring wat gekenmerk word deur tye waarin spanning en angs ervaar word. Na verskeie mislukte pogings om arbeidsterapie te vestig in Ghana het die Ministerie van Gesondheid in samewerking met die Universiteit van Ghana in 2012 'n voorgraadse program in arbeidsterapie gevestig (die eerste in sy soort in die Wes-Afrikaanse deelstreek) om arbeidsterapeute op te lei. Hierdie studie het die eerste groep arbeidsterapeute se ervarings tydens hulle oorgang van student na klinikus ondersoek, wat belangrik was omdat hulle outonoom en self-gerig moes werk vanaf die eerste jaar na hul gradeplegtigheid in 'n land waarin arbeidsterapie nog nie gevestig was nie. Doelstellings en doelstellings: Die doel was om die ervarings van die eerste groep arbeidsterapeute te ondersoek tydens hul oorgang van student na klinikus binne die eerste jaar van praktykvoering in Ghana. Die doelwitte was om die uitdagings en fasiliteerders van hul oorgang te ondersoek, die hanteringstrategieë wat hulle gebruik het om die uitdagings wat hulle teëgekom het effektief te bestuur en hul ervarings van voortgesette professionele bevoegdheid te ondersoek. Metodologie: Die navorsing het drie fases beslaan. Fase een was die ontwikkeling van 'n sistematiese oorsig-literatuurstudie protokol om die faktore wat die aanpassing van nuwe kliniese terapeute in praktykvoering beïnvloed, te ondersoek. In fase twee is die oorsig-literatuurstudie gedoen ten einde literatuur wat in die afgelope twee dekades gepubliseer is aangaande die oorgang van nuwe klinici in die praktyk te sintetiseer. Die fokus was om die uitdagings en fasiliteerders gedurende die oorgang van student na klinikus te bepaal en die bewysgebaseerde hanteringstrategieë wat gebruik kan word om die oorgang te vergemaklik te identifiseer. Fase drie was 'n fenomenologiese studie wat daarop gemik was om die oorgang van student na kliniese terapeut vir die eerste groep arbeidsterapeute in Ghana te ondersoek. Twee in-diepte onderhoude is met elke deelnemer gevoer. Induktiewe inhoudsanalise is gebruik om die data te ontleed in vier oorkoepelende temas. Etiese goedkeuring is van die Gesondheidsnavorsingsetiekkomitee van die Stellenbosch Universiteit verkry voordat hierdie studie uitgevoer is. Resultate: Daar is aanvanklik 562 studies geïdentifiseer in die oorsig-literatuurstudie; daarna is relevante data onttrek uit 24 van dié studies wat voldoen het aan die insluitingskriteria. Die data is geanaliseer en in die oorsig-literatuurstudie vervat. Vier oorkoepelende temas is geïdentifiseer, naamlik: stelsels en strukture, persoonlike kapasiteit, professionele bevoegdheid en bemiddelingsprosesse. Elke tema het die hindernisse, fasiliteerders en die hanteringstrategieë van oorgang na praktyk onder nuwe gegradueerdes toegelig. In die fenomenologiese studie het vier temas na vore gekom: ‘Om “nuut” te wees in 'n nuwe beroep’, ‘Arbeidsterapie in 'n mediese model gesondheidsstelsel’, ‘Persoonlike en professionele vaardighede’, en “Die toekoms is helder”. Daar is verder bevind dat nuwe gegradueerdes voortgesette professionele leeraktiwiteite noodsaaklik geag het vir suksesvolle oorgang na die praktyk. Gevolgtrekkings en aanbevelings: Nuwe gegradueerdes het hulp nodig om hulle kennis in die praktyk toe te pas. Nuweling-gegradueerdes het nie voldoende toesighouding gehad nie, weens gebrek aan praktiserende arbeidsterapeute. Die resultate het gewys dat goed geordende samewerking tussen voorgraadse dosente verbonde aan die universiteit en die leierskap en bestuur van gesondheidsfasiliteite, ander gesondheidsorgpersoneel en die nuwe gegradueerdes 'n suksesvolle oorgang na die praktyk kan vergemaklik. Toekomstige navorsing is nodig om die oorgang van ander groepe gegradueerdes in arbeidsterapie te ondersoek ten einde vas te stel of hulle soortgelyke ervarings sou hê. Dit sal 'n meer holistiese begrip van die oorgang na praktykvoering verskaf en verdere voorstelle genereer om arbeidsterapie-onderwys en -praktyk in Ghana te verryk.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/107894
This item appears in the following collections: