ACQ Vol 13 No1 2011

• critical thinking, analysis and reflection (Frost, 1998; Fulbrook, 1998; Rolfe, 1998). With the C-BOS document (SPA, 2001a) currently under review, it may be timely to consider whether these themes and elements of professional practice are of any relevance for defining levels of practice for the speech pathology profession from entry-level to more advanced and specialised levels of professional practice. Defining a pathway for education and training A number of health professions believe that new graduates do not necessarily possess entry-level competencies (Department of Human Services, 2005). Some professions require individuals to complete up to two years of workplace experience in addition to a base qualification. Formalised graduate training, or internships, aim to ensure that provisional health professionals participate in generalist-type training in order to achieve competency in the profession’s core competency areas. These training programs often specify requirements such as duration, location, supervision, and methods for evaluating competency upon completion of the program (American Speech-Language-Hearing Association, 2008; Psychology Board of Australia, 2010). There is agreement among the select literature reviewed that clinicians who are performing at an advanced or specialised level have done so by way of dedicated steps in career development, through setting goals and undertaking activities that will result in personal and professional development over time. For many professions, such as nursing, medicine, dentistry, and radiography in the UK, advanced practice or specialisation is associated with postgraduate education (Australian Nursing and Midwifery Council, 2009; Dental Board of Australia, 2010; Hardy & Snaith, 2007; Hardy et al., 2008; Medical Board of Australia, 2010; Podiatry Board of Australia, 2010; Price & Edwards, 2008; 2006). Some professions require individuals to substantiate their advanced or specialised competency by submitting a portfolio that satisfies the defined criteria (Australian Physiotherapy Association, n.d; Specialty Board on Child Language, n.d.; Specialty Board on Fluency Disorders, 2010), and in some cases applicants are also required to sit and pass an examination (Specialty Board on Swallowing and Swallowing Disorders, 2010). Advantages of a career and professional development framework In addition to providing a quality assurance mechanism that could protect the public by defining the level of competency expected of SPs working across the breadth of contemporary health care practice, a career and professional development framework could also offer the profession a number of other benefits. It could: • Facilitate collection of data about contemporary speech pathology practice: The expansion of the profession’s scope through the creation of advanced practice and specialisation has the potential to contribute to improved patient care, build capacity and flexibility in the health care workforce, and can also improve workforce retention. Where roles are clearly defined, this may enable the profession to collect and examine data regarding the impact of these roles on patient outcomes, and associated costs. This type of information may be valuable for particular sectors lobbying for improved award structures, fiscal and industrial conditions.

• Provide a more consistent way of remunerating different levels of practice: A structure for recognising different levels of practice may provide incentive and formalised means to support appropriate remuneration for performance that may improve job satisfaction and workforce retention. For those clinicians working in private practice, the absence of an industrial award to provide clearly defined criteria for levels of professional practice means that there is a great deal of subjectivity, and potentially unfair pay and conditions imposed on those working in that sector. A career and professional development framework could potentially address these issues, and foster the development of performance- based recognition of expertise. • Provide a more objective method of identifying experts within the profession: As with other health professions without formal career structures, expertise can be self- proclaimed (Robertson, Oldmeadow, Cromie, & Grant, 2003). A career and professional development framework could assist in the identification of specialists where there is consistency in how these individuals are recognised. • Enhance the career structure to positively affect career progression and retention: It is important for the profession to develop a strategy for how to effectively contribute to the challenges faced by contemporary and future health care demands, and actively explore the barriers that might inhibit the growth of the profession. A career and professional development framework would facilitate the mobility of the speech pathology workforce to enable clinicians with specialised skills to change jobs, move from one state to another, using a more transparent credentialling mechanism to validate expertise and experience. Furthering a career and professional development framework for speech pathology in Australia Further exploration of the idea of a career and professional development framework for the speech pathology profession is required. Ideally, this should be undertaken with representation from all sectors of the profession to ensure dynamic debate among clinicians working in established roles in speech pathology, as well as those who are at the cutting edge of clinical care, and forging ahead into new territory for the profession. The issue of who should be charged with implementing and monitoring such a framework would be a key point of discussion. Could SPA broaden its functions to include some level of practice regulation, for example, credentialling procedures for areas of advanced practice and specialisation? Or should an independent council be established to undertake governance of such a framework, aligned more with the functions of a practice regulation board? Conclusion It is imperative that the public has confidence in the competency of individuals providing speech pathology services. By clearly defining the levels of practice from entry-level and beyond, the relevant competencies, as well as training requirements to perform at these levels through a well-defined career and professional development framework, there will be a means for the public, employers, and SPs to confirm whether individuals are performing within their individual scopes of practice. Establishing a professional and career development framework for the speech

34

ACQ Volume 13, Number 1 2011

ACQ uiring knowledge in speech, language and hearing