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Robert Barnett and Ronnie Naicker, North Coast Area Health Service NSW Health Service and Paul Williamson, NSW Health
“We are here today to discuss the development of the Implementation of the NSW Health Competency Guide for Aboriginal Trainee Environmental Health Officers. Thank you and good morning. Firstly, I would like to acknowledge the traditional owners, the Irukandjii people, and the Elders present here today. We will first discuss the development of the guide, and from my perspective as a trainee I will discuss the guide. Ronnie Naicker will give a supervisor’s perspective of the guide, and Paul will give an assessor’s perspective of the guide. We will also discuss some of the challenges of the guide.
- The Guide is to train and provide support for Aboriginal people to become EHOs. In 1997 the NSW Health Aboriginal EHO Training Program was launched.
- Trainee is employed by PHU’s for six years + additional two years in NSW.
- Each trainee has to study the Bachelor of Applied Science (EH degree) through the University of Western Sydney.
- Currently eight Aboriginal Trainee EHOs in the NSW PHU Network.
As well as having to undertake our studies as trainees, our competency guide has been developed for trainees participating in an Australian program. The reasons for developing the guide are as follows:
- To ensure trainees get a diverse range of workplace skills.
- Continuous improvement tool.
- Structures their work plans and training plans.
- Clarifies roles and responsibilities of the Public Health Unit, Supervisors and Trainees.
- Developed with input from UWS, NSW Health, AIEH (NSW), Trainees and Supervisors.
- The first trial assessments by third party assessor identified some gaps in the original guide.
- Reviewed and amended per eighth Competency area developed (EH Technical Skills).
- Evidence guide is structured on a ‘stepped learning process’ of initial, middle and later year competencies, to take into account the expectation that a trainee’s competency increases as further knowledge and skills are acquired.
- All current trainees are using the guide and are being assessed annually.
Structure of Guide and how it applies
1. Competency Areas.
2. Competency Area Descriptors.
3. Competency Elements.
4. Performance Criteria.
5. Evidence Guide.
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1-3 Competency Areas, the Competency Descriptors and Competency Elements - these three sections locate the competency in terms of professional and work areas. Competency Areas describe the skills and tasks required. Competency Descriptions state the scope and the intent of the competency area, and the Competency Elements are the outcomes that combine to make up the Competency Area. The fourth section is the Performance Criteria which defines the performance area required of the trainee and it also specifies a standard of performance needed to achieve the competency elements. The last section of the Guide is the Evidence Guide, which provides on-the-job related guidance to assist trainee, supervisor and assessor understand the performance criteria. There are two levels of information in the Evidence Guide. One level provides a context for the performance criteria within the EH practice, and secondly it describes minimum standards expected to be met by the trainee before competencies can be considered satisfactory.
Competency Areas of the Guide
1. Professional Practice.
3. Environmental Health Risk Management.
4. Information Management.
6. Policy and Legislation.
7. Community Engagement.
8. Environmental Health Technical Skills.
With reference to the slide presentation, here is an example of the Structure of Guide and How it Applies using Competency 8.2 Environmental Health Technical Skills - Drinking Water Quality Management. This table is a copy of a page from the actual Competency Guide. The first column describes a competency element, in this case, quality management. The second column describes the performance criteria and the third column describes the evidence guide. As you can see, the colour shading changes in the second and third columns. The colour shading white indicates the initial year of the traineeship program which is Year 1 and 2, blue shade is the middle year of 3 and 4, and the orange shaded area 5th and 6th year competency, which are the more complex competencies that trainees must acquire.
Competency Assessment Cycle - trainees need to keep evidence of all competencies achieved in our workplace:
- Assessor assesses the trainee’s progression of the competencies he/she has achieved.
- Assessor and trainee discuss the trainee’s progress with the trainee’s supervisor.
- Assessment review by supervisor and trainee - development of training work plans.
- Training work plans forwarded to Manager of EH Unit.
- Trainee and supervisor implement plans by meeting regularly, and the next cycle starts again.
- The Guide provides trainees with a guide regarding the EH skills that are to be acquired in their field of work.
- Flexibility to acquire skills that assist with personal development through on-the-job training and courses - also gives opportunity to undertake studies in areas such as onsite management and tobacco compliance training.
- Gives trainees and supervisors a guide to develop a trainee’s annual work plan. Links work experience to academic study, eg, when studying food, able to undertake work experience with local government to conduct public food inspections (which is not able to be done in the public health unit).
- Challenges and pressures to meet all competency areas, eg, balance the needs of my family along with study and work commitments.
- With good support from family, friends and fellow trainees, self management, good time management and self motivation, the Competency Guide is a useful tool.
- The guide may assist in future employment, as it shows evidence of competencies worked towards, and work experience undertaken.
During this type of activity I would have achieved skills under professional practice, management, communication, community engagement and EH technical skills. This is a picture of Ed replacing a shower rose in a bathroom during a Housing for Health program. A program like this may allow a trainee to gain skills in all competency areas. This is a picture of Louise setting a mosquito trap during a mosquito training course. Again, Louise would have met a number of competencies during her training. This last picture shows Aunty Mim, a community water sampler, taking a water sample, checking for E.coli. I have been involved in training community water samplers like Aunty Mim, and coordinating the program. Work activities like this have assisted me and other trainees to meet a number of competency areas. For additional information on the trainee program and competencies guide there is a picture story board out in the foyer, and I invite you all to go and have a look at it”.
“Thank you Robert. I will talk about the Supervisor’s perspective:
- Supervisor’s primary role is to deliver the training outcomes expected of the AEHO Program.
- It is important to implement the guide within the period of the traineeship, eg, in Robert’s case, five years.
- A trainee’s annual work plan and monthly operational plan all need to be implemented in the work environment.
- Progression of competency element and performance criteria is written into work plans, and based on feedback and reviews.
- Ensure ample opportunity for trainees to gain technical skills internally and externally, and with a variety of activities.
- Ensuring objective competency skills are met is difficult, eg, conflict management and legislation interpretation.
- There are limitations with competency areas.
- Funding is adequate but is limited to core PHU activities which are public health protection focused, and as Robert mentioned, we don’t have a food inspection role. Therefore, that is one area where Robert needs external training.
- Team effort to ensure trainees get the required workplace skills support in order to achieve goals and meet competencies. The next slide is a photograph of a supervisor and trainee attending to a damaged water pipe in a community. This activity will cover a number of competencies when the activity is done”.
“My role in this process is to work with Ronnie and Robert in their workplace; to sit with Robert and look at documentation that will form part of his assessment, and to undertake the assessment itself. In this case, Robert’s first assessment was undertaken during his fourth or fifth year, so we had a lot to cover in terms of the guide. Other assessments have been done with other trainees who are only in their first year. The Guide is structured to try and cater for a wide range in terms of assessment situations, ie, to reflect the position of trainees with respect of their traineeship progression. As Robert said, it is meant to help trainees manage the process with their supervisors throughout their traineeship.
As an assessor it is a wonderful opportunity to work with the trainee - to gather the evidence they wish and need to present to their employer, and through me deliver the evidence to their employer so they may let them know how they feel their traineeship is going. In some cases I have also been able to facilitate ongoing discussions with their manager and the Area Health Service as they move through their traineeship.
Whilst the Guide has been developed to assist trainees as part of their employment within the NSW Aboriginal EH Training Program, the Aboriginal EH Unit recognises that trainees are not just training for EH inside NSW Health, but also for the wider EH profession. They may find future work in another environment, such as in local government, private consulting places or maybe inside community organisations. So the scope of competencies goes much broader and as Robert explained earlier, there were many people involved in the development of this Guide. The National EH Professional Competencies were also reviewed and, where possible, integrated into the Guide.
The assessment guide is evidence-based, and the process we have used provides trainees with the opportunity to document, explain and talk, take me (as assessor) out into the field, or take me to other people they work with. These activities are extremely valuable in the process. My role in the process is to document and to assist them put this evidence into a form that can be used through the other points of the assessment cycle we showed in the diagram earlier.
One of the things we have learned from the assessments is that the workplace may need to gain external assistance in order for a trainee to get through some competency areas. For example, a short-term job placement at another public health unit or in a local government or external agency office may be needed. Some trainees have already done this in areas such as septic tank inspections out in local government areas in their region, in order to see how these are regulated by local government. Some of the area health services have a very strong relationship with their local government areas while others have a very weak relationship - so there are different ways and challenges ahead.
Another major learning is that the management of competency- based training is a new process for many of the supervisors of trainees. This means that the development of the traineeship programme will need to be monitored and driven by the workplace manager. However, it is also clear that there are instances where some managers don’t have the skills to manage the implementation of the competency-based assessment process. The various PHU’s have significantly different management systems and operational focus as well. For example, the Far West AHS has a very different focus to many city-based public health units. As such, the NSW Health Aboriginal EH unit needs to identify where those gaps exist and work with the Area Health Services to roll out the Guide. This may need to involve training of Managers and Supervisors in competency-based management skills.
The assessment criteria included in the Guide focuses on skills and knowledge, not on subjective analysis. Therefore, from an assessor’s point of view, the Guide is very easy to use. The Guide structure recognises
there will be a number of stages of development in knowledge and skills, as Robert pointed out earlier. It recognises that over time the trainees’ skills will develop, and as such the document must be used over a six-years or so year process. It doesn’t expect people to just rush straight off into the whole thing. My final point highlighted through the assessments I have carried out with trainees is that the organisations rolling out this performance-based and quality management based guide may not have management systems that follow such processes. Therefore, there is a certain level of development also needed in the area health services.
This is the feedback from me as an assessor. With this next slide, Robert has asked me to continue the general presentation. The challenges that have been recognised are that the implementation of competency guides may need to be extended for a further two years. Robert pointed out that the traineeship includes the degree course, which is for six years. They do have their option there of an extra two years in the workplace, and I think that’s where this point is being targeted. That is, it’s about extending the competency guide into areas when they have become qualified, so it’s a point about bridging between the traineeship and their professional practice. For example, some skills require formal EHO authorisation before they can be gained. In some competency areas the bar may be high, but it is a work in progress and there is a mechanism through the Aboriginal EH Unit in Sydney to continue to review the guide. So these points may be taken up by them.
In conclusion training Indigenous people is about getting people to make a difference in improving EH in their communities, and in the areas of health services in which they are working.
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- Aims to ensure consistency, and provide a mechanism of fairness in terms of the development of their skills.
- Provide a ‘blue-print of what is required by all parties (the trainee, the assessor and anybody else they relate to or from where they are getting their training), and it should not be underestimated that part of the training may need to be provided by third parties.
- Is a continuous improvement tool with steps and stages.
- Assists with employability for trainees.
- May increase job satisfaction and EH retention.
Before we finish, we would like to make the following acknowledgements to:
- NSW Health Aboriginal Environmental Health Unit.
- Project Officer, Paul Williamson.
- NSW Health Aboriginal Trainee Environmental Health Officer Network
- NSW Health Public Health Unit Network.
- University of Western Sydney.
- Australian Institute for Environmental Health (NSW Div)”
Questions:Q1. Pat Nichol, Wujal Wujal - “Regarding the receiving of the program in the Far West areas like areas out here, how well is it received? Do you get a lot of trainees in those types of areas”?
A1. Paul Williamson - “Correct me, but are you asking whether there are trainees in the Far West”?
Q2. Pat Nichol - “Yes. How well is it received in remote communities”?
A2. Paul Williamson - “In my other work with the area health service out there, I am based in the greater western area which is basically Dubbo west. I have involvement with Thadd Nagas, who is the trainee out in that area, and also with another group of people called Healthy Housing Workers who are working out there. These are not at the degree level, but are VET level trained. I believe it has been well received in terms of their interface with the communities, but we could ask Thadd, too, in that regard and how well it’s received. He probably has a stronger perspective on that”.
Thadd Nagas - “I am a trainee similar to Robert. I am out in the far west and there’s another trainee by the name of Trevor Robinson also working based in Dubbo. The Competency Guide itself is accepted by both of us trainees out there. There is also an EHW (Healthy Housing Worker program out there which has been part of the COAG trial). It’s been a long process and it’s been accepted in communities. We have been able to get a lot of work done in communities that wouldn’t even get touched by an EHW, so it is working well”.
For further information
PO Box 126, Port Macquarie, NSW 2444
Ph: 02 6588 2992 Email: firstname.lastname@example.org
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