Dynamic Accountability in Clinical Training and Supervision: Three Orienting Ideals (original) (raw)

Despite the growing interest on making clinical practice accountable, research on how specific components of professional competence are relevant in actual training/supervision practice is as yet unspecified. This study explores this dynamic aspect of professional supervision. Three supervisory dyads, composed by an experienced supervisor and a doctoral counselling psychology student were used in the study. A qualitative, ethnomethodology-informed design was used to discursively analyze 16 significant episodes (SEs) in actual supervision meetings. This was complimented by 16 follow-up interviews. Three interpretative repertoires – “ideals” – influencing participants’ accounting practices were identified: efficacy, responsiveness, and authenticity. The article discusses how structural (competency-based) and dynamic (practice-based) approaches to accountability can be combined to guide the appraisal of relevant professional competencies. Keywords: Accountability, Professional Competence, Clinical Supervision, Supervision Process. Joaquin Gaete Silva - first author

Re-thinking professional development and accountability: towards a more educational training practice

International Journal for Transformative Research, 2015

In this article, I discuss the contribution of theoretical resources to the transformation in my thinking about professional development and accountability, within an action research self-study of practice as a civil servant, in the context of participation on the Doctor in Education (Leadership) programme at Dublin City University (DCU) in the period 2008-2012. It is at the intersection of these subject positions, between theory and practice, that professional development was explored through the ‘leadership problem’ of encouraging trainer colleagues to investigate the educational potential of information and communications technologies (ICT) for the development of their practice. Ultimately, this constituted a critical space for sustained dialogue between the self and the social in exploring professional subjectivity. The resources discussed supported the interrogation of social, cultural and historical conditions influencing self-understanding and narrative reasoning (Tamboukou, ...

Towards accountability-centred practices: governance in OSCEs subordinating patient and practitioner clinical experience

Advances in Health Sciences Education

New public management ideals and standards have become increasingly adhered to in health professions education; this is particularly apparent in high-stakes assessment, as a gateway to practice. Using an Institutional Ethnographic approach, we looked at the work involved in running high-stakes Objective Structured Clinical Exams (OSCEs) throughout an academic year including use of observations, interviews and textual analysis. In our results, we describe three types of ‘work’—standardising work, defensibility work and accountability work–summarising these in the discussion as an Accountability Circuit, which shows the organising role of texts on people’s work processes. We show how this form of governance mandates a shift towards accountability-centred practices, away from practices which are person-centred; this lens on accountability-centring during high-stakes assessments invites critique of the often-unquestioned emphasis of new public management in health professions education.

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