Occupational therapists' views on core competencies that graduates need to work in the field of neurology in a South African context
African Journal of Health Professions Education
Research The South African (SA) population is burdened by a prevalence of neurological conditions, such as congenital, acquired and progressive disorders.  Given the effect of neurological conditions on a person's quality of life, these form a sizeable proportion of an occupational therapist's workload in school and healthcare settings.  The assessment and treatment of persons with neurological conditions are included in undergraduate occupational therapy courses to prepare students with
... pare students with the necessary competencies to work in this field. There are regular changes in the practice of neurology, given constant research developments in the domains of neurological assessment and treatment. Service provision is often characterised by limited resources, short and intermittent therapeutic input and a high therapist-client ratio.  Therapists have alluded to the existence of possible gaps in the core knowledge and skills of the students they supervise in the clinical field. This highlighted the need for revision of the neurology curriculum at a university in Western Cape Province, SA. The current curriculum at this university is structured in such a way that students are taught physiology, anatomy and assessment of neurological components in their second year of study. The treatment of neurological conditions is taught in the classroom and in clinical settings throughout the third and final years of the academic programme. The relevance and need for a curriculum to be responsive to the needs of the community have been highlighted by Frenk et al.  These authors highlighted that the health professional of the 21st century requires additional tools to be a competent practitioner. They stressed that traditional training focused on the first two levels of learning, i.e. informative (learning of facts and skills) and formative (elements required to become a professional). They argue that students, however, also need to be exposed to transformative learning to ensure that the population's health needs are met, inequities are minimised and deficiencies in health systems are addressed. Frenk et al. 's  theory on transformative learning was the conceptual framework underpinning this research. Within this framework, students need to become agents of change through their experiences of teaching and learning at a university. To ensure that learning is transformative, it is essential that the undergraduate occupational therapy neurology curriculum is relevant and responsive. The relevance and responsiveness may therefore be facilitated through the use of a collaborative approach to curriculum design.     Such an approach between clinicians and academic staff is essential to ensure that the knowledge, skills and attitudes that are taught, mirror what graduates need to provide, i.e. comprehensive, effective and efficient service within a given community.  Studies using a collaborative approach to develop curricula have been conducted in various fields of occupational therapy, e.g. paediatrics, [9, 10] adult physical dysfunction  and gerontology.  A review of the literature has demonstrated that collaborative curriculum design in the field of neurology is limited and studies were either conducted in high-resource countries or focused on a single diagnosis in neurology, such as a cerebrovascular accident.    13] A study that explored the core skills and knowledge that an occupational therapy-specific undergraduate neurology curriculum should foster to enable graduates to provide interventions across all age groups and Background. The burden of neurologically related conditions in South Africa (SA) necessitates that undergraduate occupational therapy education and training provide students with core competencies to deliver comprehensive, effective client-centred interventions. Given developments in the practice of neurology and changes in policy, funding and infrastructure, it is essential that training remains relevant and responsive to the needs of individuals and their context. Occupational therapists should be in touch with the local context and its challenges and consider the practicalities of the suggested interventions. Objectives. To explore occupational therapists' perspectives on the knowledge, skills and attitudes that graduates need to work in the field of neurology. Methods. An explorative qualitative study consisting of semi-structured interviews was conducted with 10 occupational therapists in Western Cape Province, SA. Data were analysed using inductive analysis. Results. Four themes emerged from the findings, including foundational knowledge and skills, intra-and interpersonal attitudes, suggestions to consider when revising a neurology curriculum and resource constraints. Conclusions. This study highlighted that, in addition to neurology-specific skills, graduates also require core generic knowledge, skills and attitudes that address the evolving needs of society. These competencies are further necessary to allow graduates to work within the constraints of the health and educational systems.