Evidence for recency of practice standards for regulated health practitioners in Australia: a systematic review

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Abstract

Background

Health practitioner regulators throughout the world use registration standards to define the requirements health practitioners need to meet for registration. These standards commonly include recency of practice (ROP) standards designed to ensure that registrants have sufficient recent practice in the scope in which they intend to work to practise safely. As the ROP registration standards for most National Boards are currently under review, it is timely that an appraisal of current evidence be carried out.

Methods

A systematic review was conducted using databases (including MEDLINE, EMBASE, PsycInfo, and CINAHL), search engines, and a review of grey literature published between 2015 and April 2022. Publications included in the review were assessed against the relevant CASP checklist for quantitative studies and the Joanna Briggs Institute checklist for analytical cross-sectional studies.

Results

The search yielded 65 abstracts of which 12 full-text articles met the inclusion criteria. Factors that appear to influence skills retention include the length of time away from practice, level of previous professional experience and age, as well as the complexity of the intervention. The review was unable to find a clear consensus on the period of elapsed time after which a competency assessment should be completed.

Conclusions

Factors that need to be taken into consideration in developing ROP standards include length of time away from practice, previous experience, age and the complexity of the intervention, however, there is a need for further research in this area.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12960-023-00794-9.

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Most cited references 32

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A systematic review of retention of adult advanced life support knowledge and skills in healthcare providers.

Chih-Wei Yang, Zui-Shen Yen, Jane McGowan … (2012)

Advanced life support (ALS) guidelines are widely adopted for healthcare provider training with recommendations for retraining every two years or longer. This systematic review studies the retention of adult ALS knowledge and skills following completion of an ALS course in healthcare providers. We retrieved original articles using Medline, CINAHL, Cochrane Library, and PubMed, and reviewed reference citations to identify additional studies. We extracted data from included articles using a structured approach and organized outcomes by evaluation method, and knowledge and skills retention. Among 336 articles retrieved, 11 papers were included. Most studies used multiple-choice questionnaires to evaluate knowledge retention and cardiac arrest simulation or other skills tests to evaluate skills retention. All studies reported variable rates of knowledge or skills deterioration over time, from 6 weeks to 2 years after training. Two studies noted retention of knowledge at 18 months and up to 2 years, and one reported skills retention at 3 months. Clinical experience, either prior to or after the courses, has a positive impact on retention of knowledge and skills. There is a lack of large well-designed studies examining the retention of adult ALS knowledge and skills in healthcare providers. The available evidence suggests that ALS knowledge and skills decay by 6 months to 1 year after training and that skills decay faster than knowledge. Additional studies are needed to help provide evidence-based recommendations for assessment of current knowledge and skills and need for refresher training to maximize maintenance of ALS competency. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

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Evaluation of staff's retention of ACLS and BLS skills.

Kimberly Smith, Darlene M. Gilcreast, Karen Pierce (2008)

To test registered nurses' abilities to retain basic or advanced life support psychomotor skills and theoretical knowledge. A repeated-measures, quasi-experimental design was used. Written and performance tests (initial, post-training, and final testing) used scenarios requiring performance of advanced cardiac life support (ACLS) or basic life support (BLS) skills. Final testing was by random assignment to 3, 6, 9, or 12 months. A convenience sample (n=133) was used. American Heart Association 2000 ACLS and BLS evaluation tools were used in a simulated testing environment. Findings show nurses retain theoretical knowledge but performance skills degrade quickly. ACLS skills degrade faster than BLS skills with 63% passing BLS at 3 months and 58% at 12 months. Only 30% of participants passed ACLS skills at 3 months and 14% at 12 months. These findings are similar to the results of other investigators in over a decade of research. Study results showed a decline in skills retention with nurses unable to perform ACLS and BLS skills to standard for the entire certification period. The need for more frequent refresher training is needed. No formal research at this institution indicates skill degradation adversely affected patient outcomes. Further research on ACLS and BLS course content, design, management, and execution is needed.

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Is Open Access

FORM: An Australian method for formulating and grading recommendations in evidence-based clinical guidelines

Susan L. Hillier, Karen Grimmer-Somers, Tracy Merlin … (2011)

Background Clinical practice guidelines are an important element of evidence-based practice. Considering an often complicated body of evidence can be problematic for guideline developers, who in the past may have resorted to using levels of evidence of individual studies as a quasi-indicator for the strength of a recommendation. This paper reports on the production and trial of a methodology and associated processes to assist Australian guideline developers in considering a body of evidence and grading the resulting guideline recommendations. Methods In recognition of the complexities of clinical guidelines and the multiple factors that influence choice in health care, a working group of experienced guideline consultants was formed under the auspices of the Australian National Health and Medical Research Council (NHMRC) to produce and pilot a framework to formulate and grade guideline recommendations. Consultation with national and international experts and extensive piloting informed the process. Results The FORM framework consists of five components (evidence base, consistency, clinical impact, generalisability and applicability) which are used by guideline developers to structure their decisions on how to convey the strength of a recommendation through wording and grading via a considered judgement form. In parallel (but separate from the grading process) guideline developers are asked to consider implementation implications for each recommendation. Conclusions The framework has now been widely adopted by Australian guideline developers who find it to be a logical and intuitive way to formulate and grade recommendations in clinical practice guidelines.

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Author and article information

Contributors

Sarah Anderson:

ORCID: http://orcid.org/0000-0002-9932-3285

Sarah.anderson@ahpra.gov.au

Journal

Journal ID (nlm-ta): Hum Resour Health

Journal ID (iso-abbrev): Hum Resour Health

Title: Human Resources for Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1478-4491

Publication date (Electronic): 24 February 2023

Publication date PMC-release: 24 February 2023

Publication date Collection: 2023

Volume: 21

Electronic Location Identifier: 14

Affiliations

[1 ]GRID grid.468032.b, ISNI 0000 0000 9487 6740, Australian Health Practitioner Regulation Agency, ; GPO Box 9958, Melbourne, VIC 3000 Australia

[2 ]GRID grid.1018.8, ISNI 0000 0001 2342 0938, La Trobe University, ; Bundoora, VIC Australia

Author information

Sarah Anderson http://orcid.org/0000-0002-9932-3285

Article

Publisher ID: 794

DOI: 10.1186/s12960-023-00794-9

PMC ID: 9951142

PubMed ID: 36829163

SO-VID: 5f0cadd1-911c-44bf-9e53-014229cd0ba5

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 29 August 2022

Date accepted : 18 January 2023

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ScienceOpen disciplines: Health & Social care

Keywords: recency of practice,skill retention,health practitioners,regulatory standards,systematic review

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ScienceOpen disciplines: Health & Social care

Keywords: recency of practice, skill retention, health practitioners, regulatory standards, systematic review

Evidence for recency of practice standards for regulated health practitioners in Australia: a systematic review

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Most cited references 32

A systematic review of retention of adult advanced life support knowledge and skills in healthcare providers.

Evaluation of staff's retention of ACLS and BLS skills.

FORM: An Australian method for formulating and grading recommendations in evidence-based clinical guidelines

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