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Functional analysis andoccupational standards: their role in curriculum development
Functional analysis and occupational standards: their role in curriculum development Les Storey National Vocational Qualifications and national occupational standards have been criticized by many academics and professionals, seemingly without a true knowledge of the processes and principles that underpin their development. This paper attempts to clarify the role that functional analysis and occupational standards can play in meeting the demands of central government and purchasers in providing educational programmes that meet individual, organizational and society's needs. An overview of the processes and principles relating to functional analysis and occupational standards is provided, and issues arising from their incorporation into professional education programmes are debated.
Background
Les Storey RGN, MSc, PGDipHE, Dip Training
Management, Senior Lecturer, University of Central Lancashire,Ormskirk Campus, Ormskirk DGH, Wigan Road, Ormskirk L39 2AZ, UK
Since the advent of National Vocational Qualifications (NVQs) within health and social care, the response to methodologies used in their development has been diverse: some professionals and academics have disregarded their relevance, whilst others have embraced the concepts and have integrated aspects of best practice from both the academic and vocational approaches into personal and professional development educational programmes. Functional analysis is a process that underpins the development of occupational standards, and subsequently, NVQs. Functional analysis is a holistic, systems-based analysis approach used to analyse whole occupations in terms of outcomes and the purpose of work activities rather than specific activities, procedures and methods. This approach is used to facilitate the development of national occupational standards which are presented in the form of a functional map (a sample of a functional map of the trade union sector is shown in the Figure). Jessup (1991), in his description of functional analysis, stated that 'The analysis and specification of competence according to functions, which is now advocated, provides a
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broader conception of competence than earlier task analysis approaches. The concentration on function shifts the focus of competence from tasks and procedures to the purpose and outcome of work activity' (Jessup 1991, p 27). National occupational standards define the level of performance required for the successful achievement of work expectations. They specify best practice in an employment sector and are expressed in the form of elements of competence, performance criteria and range indicators. The range indicators are used as specifications for assessment when standards are aggregated together to form qualifications. NVQs are qualifications based on standards developed through the process of functional analysis. NVQs are a selection of units of competence from a set of occupational standards endorsed by the employment sector's lead body, which meet criteria laid down by the National Council for Vocational Qualifications (NCVQ) now the Qualification and Curriculum Authority (QCA). Functional analysis gives educational providers a holistic view of the employment needs of an occupational area and enables them to develop a curriculum that reflects these needs. The outcome of functional analysis is a functional map, which outlines the key purpose, key areas
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Functional analysis and occupational standards
Key purpose: Protect, maintain and imp~ve the coll~5ve and indlvidual employmen~ ¢ondi~ons, employment opportun~ies, status ~ d social well-being of membe~ ~ defned through the decision-making proc~ses of trade unions
A Contribute to the s~mte&ic direction of trade unions and the fo~ation ~ d imp]emenc~ion of ~rade union policy
A~
InBuenceand contribute to the po~icymaking p r o x i e s and the s~te~ie di~cdon of ~ade unions
ALl AI.2 AI3 AI,4 AI,5
Iden:ify and ~ l u a : e signTfic~t sod~J ~ d economlc fac~o~ which affect the fu~u~ de~lopmen: of t~de ~nio~ Develop and propose a ~dslon~ d strategi~ for the future direction of :he t fade unions
Developandadv]~onpo[icyor/donsthatmeetiden~fiedp~orit~dsU'ategies Develop s y s ~ s and processes for the implementation ~ d monitoring of policy derisions
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Suppol~ govern~r~, bodies in the interpretatlon and implementation of t~ade union policy
A3
Support the poIicyrnaking proc~s~ of trade unions
51
Rep~ent ~ d promote the ~mageand policies of t~de unions
5L I BL2 BI,3 BI.4
B2
Support acciviri~ and c~m5algns within the polid~ of I~ade uniom
B2.1 Propose, develop & implement strategies ~ d policies ~or the politi~l direction ~ d ~ctMt[es of trade unio~ B2.2 Pl~andmonitortheimplementa:ionofpol]ticalactiv~tiesandcamp~gns B2.3 Co~tdbete to acti~c~es~ d campaiB~
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C2
Develop recognition r~hts with employe~
C2.1 C2.2 C2,3 C2.4
Id~dfy ~ d make contact with employe~ Negotiate bargalnff~ r ghts v~th e mptoye~
A~3
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A2.4 Develop~dpropo~ope~tlonaIplansf~implemendngdecisio~ A3,1 Provide info~aBon and ath4ceto e~ble others to formulate, interfim~ and follow policy decisions A3,2 Enable membe~ to formulate, interpret ~ d foIIow policy decisions
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C Develop ~ d orgar=izethe membe~hip ~ d rep~enta:ive structures of trade unions
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C3,1 C3.2 C3.3 C3.4 C3.5
Ran ~ d monitor the development of l~al org~i~t~on Promote ~ d enlist sufipor~ for prlonty collec~ve bargaining issues Deve~op ~ d p romote a workplace coIlecBve berthing agenda Provide resources ~ d ~d~ce ~o develop systems ~ d strategies
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Contribute to the negotiation of terms and renditions of ~rade union membe~
DI.I DI.2 DI.3 D[.4 DL5 DI,6 DI.7
Ob~a~n,lnterp~etandsumm~a~zelnformation:osupportnegoBatio~ Ad~iseontheconductandstrategyofnegoti~tio~
D2.1 D2.2 D2.3 D2.4 D2,5
Advbeonthev~hdityandcr~dibif~yof~es Provide info~a:ion and ~ o u r c ~ to enable othe~ to p ~ p a ~ ~ e ~ P~pare ~ for p~ent~:ion and m p ~ s ~ t [ o n P~t ~ to employe~
D3.[ D3,2 D3.3 D3.d
Pro~ideirfformation~dadvicetomembe~onh~[th,~fetyandwelfarematters Investigate~dreportonpotendalh~dsintheworkplace I~tigate~dreportonthe~usesofaccidentsandinddents Contdbutemtherep~entat~onofthehe~dth,safety~dwelfa~inte~stsofmembers Develop ~d implement new member se~ic~ Monitor and improve the quality of se~ice delivery
D2
Representtheindiv[dualandcollective
inte~tsoft~deunio~membe~
Monitorandimpmvethebeabh,~fety~d
Contribete to negod~t[ng teams Refer ~ e s to ~ndii~tion and ~bit~tion services Ewdu~te ~ d p r ~ s the acceptance of offers and agreements Finali~ ~ d r~ord aB~emen~ Contffbute to the ~ l u t i o n of industrial dispu~
Presentc~to]ega[IyconsUtutedadjudicaBngbodies
Develop and provide se~ices for trade union membe~
E I. I Eh2
B2
Commi~ion se~ic~ that meet the needs of ~ d e unlon membe~
52. I Set standards and spociBcat~onsfor the prov~slonof member se~ic~ E2,2 I d e n ~ and select suppliers of member sewiees E2.3 Support ~ d ad~se supplie~ on the implementation of member se~i~s E2.40btalnandfe~dbackinform~tioninser~cequality E2.5 Contribute to ~he improvement of ser~ce delh/ery
E3
Provide spedafi~ irdormaBon and advice to colle~ues ~ d membe~
Standards from the Advice, Guidance ~ d Counselling Lead Body, plus specialist Imowledge ~ d skills appropriate to the sp~iallsm
Develop ~ d provide services to ~rade u~ion membe~
Contribute to effecdve admlnist ~tion and communication systems
Promote,supportandadviseonp~;dcip~t~vestmctur~andpmce~
EI
£ 4 0 b ~ J n and provide information and acMce to tr'ode union membe~
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Rep~ntun~onpollcyandmemberinte~ts
Oeve~op l~ade union o rg~iz~Bo n
welf~eoftradeunionmembe~
•_•F
Prep~e and p~sent irdormadon on b r o a d ~ t media
C3
P~tect and imbrue the employment conditions of trade union members
Promoteopportuni~ for the achievement of equaTity~ d personal development
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Maintalncontactwithemp~oye~dpromotethebeneBtsof~cognition P~momtheindustri~lreladonsbeneBtsofco[lectiveaB~emen:stoemploye~andmembe~ C2.5 PL~n~dmon~orthedeve~opmentofconsultath~estructur~dprocedur~
D3
_•IE
D~elop, implement ~ d e~luate pmmoponal st~ $ e ~ ~ d policies
f i 4 , 1 0 b m l n , pt~vTdeand int~pr~t informatio~ about unionsendces E4.2 Presentinfo~Bontogroupsofmembe~ E4.3 SUBportandad~semembe~onmatte~ofper~na[coneern
Promote equafd' of opportunity for all t~de union mBmbers
FI.I Promote the elimination of discrimination F 1,2 ~onKor and report o~ the progr~s of eq~[ opportunity policies and initi~t~v~
F2
Contribute to po~o~l and team development
F2,] Identify and select pe~onal ~du~tion and development programmes B2.2 Setpr[oritiesandmonitortheallocationofresources F2,3 Establish and main:~n effectivet ~ relationships with : ~ membe~
G[
Contributetotheeff~tlveadminist~tion of t~de unions
G[.I Inidateandm~nt~Jnorga~fzational[nformaBonandcontaetne~orks GI.2 Lead ~nform~l meetings and 5mup discussio~ to solve p~blems ~ d mzke derisions G I 3 0 r g - , m i z e and ~rvFce meetings and committ~s Gh4 Chairand~portontheprogr~s~dou~com~offo~almee~ings GI.5 Present information to mee~ngs G I . 6 0 ~ g i n a t e and r~pond to written corresponden~ GI.7 P,~cord~ d store iofo~ation
G2
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G2.[ Init~at~dmalnt~dnper~nallnformadon~dcon~ctnet~rks G2.2 Select and adapt ~ i t t ~ materials
G3
Provide administrative suppor: se~ic~ to t~de union, their staff and membe~ (Standards and Qual~:ion~ from the Administr~tNe Lead Body)
HI
Cont~bute ~othe fin~cial n~n~gemen~ of trade unions ~u~dtheir assets(St~dards and QualiBcaBons from the Accounting Lead Body)
H2
~nitiat~andim~Iemen~h~5e~nse~ces~dsystems(Uni~M[~/~r~mtheManagementC~armr~nitiat~vefitandards)
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Mon~tor,maint~n ~ d improve ser'Ace delivery (Unit HII/2 from the M~aBement Charter Inidatlve 5tand~ds)
H4
M~n[t~r~dc~ntr~theu~ofr~u~(UnitM~/3fr~mtheManagementCh~r~er~ndia~veStandards)
145 A~cate r~u~es f~r a~iviB~ and pr~i~ts (Unit M~I/4fr~mthe M~gement Char~er~n~ti~BveSt~d~ds) H Contribute to the eff~tive management of t~ade union operations
]-16 Esmb~ish and malnt~ n poI]cies for the r~mitment of staff (Un~ MII/5 from the Management Charter Initiative S:~dards) H7
Deve~p~e~s~indMdua~sand~ f t~en~anceperf~rmance(Un~tM~/6fr~mthe Man~ementCharter]nhiadveStandards)
H5
P~an'a~ocate~deva~uatew~rkcarr~ed~utbyteams'ind1vidualsandse~f(UnitMH/7fr~mthe~an~ementCharter~n~tia~veStandards)
H9 Cr~teandmainmine~ectiveworkin~re~at~nshEps(Un~cM~8fr~mtheMan~ementC~a~er~nida~veStandards ) H I0 Seek, evaluate 2nd organize infor~Bon for action(Unit MII/9 from the Management Charter In~iaUveStandards) H I I Exchange ~nformadon to solve problems and m~ke dedsiom (Unit MI[/I 0 from the M~agement Charter ~nitia=iveStandards) P~pared for the Trade Union Sector Developmer~ Body by PRIME R~earch ~ d DeveIoBment Ltd November 1995,
Figure A functional map of the trade union sector.
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Functional analysis and occupational standards
and key roles that are required to provide a service to patients. A functional map is normally symbolized as a 'fallen tree' (as in the Figure), which illustrates the stages of analysis and disaggregation that result in the development of occupational standards. Occupational standards are statements of competence; national specifications for performance, which include the ability to perform in a range of work-related activities. With the underpinning skills, knowledge and understanding required, they describe what should happen in employment (NCVQ 1989, Mansfield & Mitchell 1996). Functional analysis suffers from inappropriate links to 'functionalism', a 1960s approach to the description and analysis of social action. It also suffers from claims of 'reductionism, mechanistic, conforming, resistant to change and deterministic' (Mansfield & Mitchell 1996, p 99) which stems from the analytical approach used to determine occupational standards. Mansfield & Mitchell (1996, p 101) report that functional analysis has its origins in the hermeneutic and dialectical traditions of social science, relating to the social theories and methodologies of interpretative understanding, which reject the reductionist and behaviourist approaches that attempted to define and analyse social action using empirical methods adopted by the natural sciences. They go on to say that functional analysis was developed 'for the sole purpose of developing descriptions of human capability.., by concentrating on the expectations of employment, broken down through a process of structured analysis which eventually produces a level of detail which we describe as an occupational standard' (Mansfield & Mitchell 1996, p 101).
Functional analysis: the process Functional analysis determines the key purpose of an occupational area through consultation with the job holders (experts). The analysis identifies current best practice and balances these against realistic future expectations. The key purpose and key roles of the occupation are determined by asking practitioners simple, but searching, questions, such as: • What are you seeking to achieve? • What are the expected outcomes of your work?
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• What are the values that underpin and ~:ensio~s that impinge on your delivery of care? From the responses, analysts are able to produce a 'map' of the occupational area, which includes key purpose and key roles. Key roles are then broken up into subsets of units n~tade up o:f performance standards. It is this process of breaking up or disaggregating a role that alarms many educationalists. Dymott (1994) supports this view by stating that NVQs could result in nursing becoming a deskilled and mechanistic profession. However, Oakes (1994), Eaton (1994), Storey et al (1995) and Mansfield & Mitchell (1996) argue that the adoption of NVQs and the use of occupational standards does not necessarily lead to task orientation (or mechanistic practice). Wolf (1994, p 3) points out that the process ef defining standards in terms of units, elements, performance criteria and range statements, means that what is integrated in reality is often disaggregated in the assessment specification for an NVQ. However, as Mansfield & Mitchell (~996, p 127) point out it is important to keep occupational standards and NVQs separate. NVQs are but one of the ways in which occupational standards may be used. Occupational standards can be used in a variety o~ ways: to define job descriptions; to provide a benchmark for individual and organizational development; as a means of assessment of performance; as a tool for training needs analysis; and to form qualifications.
Specificity of standards A contentious issue in discussions about standards concerns the optimum level of specificity. If there is too little specificity, the result may be a lack of clarity, poor communication and diminished credibility. On the other hand, too much specificity can lead to standards that take too long to read, are cumbersome and can lead to abuse of the sys~tem by people taking short cuts. This criticism has been directed at the national occupational standards from certain occupational areas, although it is accepted that different parts of thee same set of occupational standards may requiire different levels of specificity (Eraut & Cole 1993, CBI 1994, Beaumont 1996).
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If one role of standards is to establish a reasonable level of agreement and common understanding about the definition of competence, it is true that well defined standards will do this more effectively than poorly defined standards. It must be recognized, though, that there are limits to what written standards can achieve on their own. Total uniformity of interpretation is an unattainable goal. The formulation of standards involves a great deal of professional judgement. The variations in work role and working practice between one job and another within an occupational area can be quite large. It is important that standards are based on a thorough analysis of the nature of professional work and its knowledge base. There should also be an assumption that some capacity for change should be built into the standards themselves in order to ensure that students and professionals are not judged by out-of-date criteria, and that there is a clear statement of the methodology and rationale used to derive the standards which should be documented in an explicit way (Eraut & Cole 1993, p 25). Functional analysis does this, in that the outcome of the analysis is a functional map which outlines the key purpose, key roles and functions of the occupational area.
The use of occupational standards As previously described, occupational standards can be used in a number of ways, one of which is in qualifications, commonly NVQs. NVQs describe what an individual can do: they are national, and cannot be adapted to meet employment requirements in the way that occupational standards can. The requirement that candidates must provide evidence of having met the performance criteria for each element within an NVQ has led to some assessors believing that separate assessment is required for each performance criterion to ensure competence. This approach can adversely fragment teaching and learning and is at odds with the development of 'breadth' of competence. Complex and integrated tasks need an element of broad assessment that takes into account the overall quality of work as well as the ability of the students to reflect and adapt their practice. The Employment Department (1993) points out that the essential knowledge and understanding
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that underpin performance should be specified within occupational standards and highlights that, in general the higher the level of NVQ, the greater will be the proportion of evidence drawn from knowledge and understanding. Incorporating occupational standards into programmes of learning enables the students to not only demonstrate their skills, knowledge and understanding, but also to apply them in the context of their work settings. NVQs have established their position in the framework of qualifications within the UK. This has been reinforced by the Dearing report (1996), which equated a level 3 NVQ to an 'A' level within a national framework of awards. However, there is still reluctance to embrace NVQs at higher professional levels, although many professionals are starting to incorporate occupational standards into their diploma and degree programmes, e.g. Social Work and Professions Allied to Medicine. Higher education has already recognized the potential of NVQs: a survey (HEQC 1995, p 22) shows that 48 universities and 4 higher education colleges have been accredited to offer NVQs. In particular, the Vocational Qualifications Unit of the Open University has pathways that allow for both vocational and academic accreditation of programmes. NVQs as a framework of qualifications may not be attractive to some health care professionals: this may be as a result of confusion over their currency and relevance to professional development. However, the processes, particularly functional analysis, involved in the development of national occupational standards which are fundamental to the development of the qualifications, are proving to be beneficial in the production of curricula for professional development, as demonstrated by Norfolk & Norwich (Edwards 1996, p 6) and the Royal Liverpool & Broadgreen NHS Trusts (O'Hanlon & Andrews 1996). These Trusts are just two examples of ongoing work to develop frameworks of occupational standards for continuing professional development for professions supplementary to medicine and for clinical nursing practice.
Critics" views In spite of the move to increase the uptake of this methodology within the professional arena, there
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Functiona/ analysis and occupational standards
are still critics of the processes involved. It is the process of analysis and disaggregation of functions that has been criticized by a number of authors, including Le Var (1996) and Clark (1993). They suggest that this process is failing to meet the needs of nurse education. However, what they and many others fail to acknowledge is that functional analysis has the potential to provide a means for developing curricula that meet current and future employment needs within the health care sector. Within health and social care there has been significant progress in the development of occupational standards for professionals. However, nursing appears to have dismissed the benefits and potential that can be derived from their use. In a recent article, Le Var (1996) critically examined the process of assessment associated with NVQs. She concluded that, 'On the basis of research evidence of the effects of assessment on learning, assertions have been made regarding the likely effects of the NVQ approach to assessment on learning. These effects do not match the requirements of professional education and training aimed at producing a competent practitioner' (p 87). This opinion reflects the views of other academics and professionals. Professor June Clark has stated that NVQs and occupational standards were potentially undermining professionals by reducing the qualifications required of them to a list of technical skills. Her major anxiety was that pre-registration education was slipping out of the profession's control. Another of Clark's worries was that professional education for nursing would gradually replaced by employer-led vocational training: 'a step back of more than 50 years' (Clark 1993, p 7). She also pointed out that preparation for nursing needs an intellectually stimulating, research-oriented, multidisciplinary approach. 'The socialisation process of the present vocational training system militates heavily against the creativity and intellectual curiosity.., required for research and adaptability" (Clark 1993, p 7). These views demonstrate a lack of understanding of the processes involved in the development and implementation of national occupational standards, and fail to acknowledge the changing needs of health care and education.
Educating the future workforce It is accepted that a skilled and knowledgeable workforce is essential to achieving many of the
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strategic objectives highlighted by a variety of policy documents and reports, including Caring for People (DOH 1989), The Patient's Charter (DOH 1991), The Health of the Nation (DOH 1992), A Vision for the Future (DOH 1993), The Future Hedth Care Workforce (Conroy 1996) and Primary Care The Future (DOH 1996). Education and training for health care professionals has to take account of these and future policy changes if they wish to produce the competent and relevantly educated practitioners of the future. It is essential that the products of nursing faculties and departments in higher education are viewed as 'fit for purpose', whilst also perceived as providing 'value for money'. This view is highlighted by the Department of Health (1994) in its statement of strategic intent for the nursing, midwifery and health visiting professions, and in recent executive letters, for example EL(95)96 (DOH 1995), where the use of occupational standards in educational programmes is advocated.
Occupational standards and professional development Approaches to the integration of occupational standards within higher education have been attempted in a number of institutions. The conference proceedings from the Universities Association for Continuing Education (1996) record a number of initiatives where occupational standards and traditional higher education processes are being merged. One paper in particular (Parker 1996, p 39) reflected on experiences of using NVQs in higher education and the comparability between professional curricula in higher education and NVQs. In spite of inherent differences between the models, several ways of integrating the two approaches were suggested. These included: • The incorporation of NVQ units accredited within higher education curricula. This would[ involve linking pure knowledge (higher education focus) with competence (NVQ focus) by assessing understanding in the workplace • The development of portfolios of NVQs at levels 4 and 5 after obtaining a university certificate or diploma.
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Recognition that management lends itself to NVQ awards, but that there are difficulties with other disciplines. • Progression can be built into NVQ achievement, but only in terms of closing the gap between an individual's present and desired future performance (Parker 1996, p 39).
range of institutional and non-institutional settings (UKCC 1986). Day & Basford (1993) point out that since the inception of Project 2000, commentators have questioned the ability of nurse education programmes to achieve the desired outcome of a 'knowledgeable doer'. They report that some people view Project 2000 students as lacking competence and confidence, compared with Occupational standards and the students who have undertaken traditional nurse pre-registration curriculum education and training programmes. In an attempt In certain respects, these models of integration of to address this perceived imbalance, many higher occupational standards have already been education institutions offering nursing attempted within nurse education programmes. A programmes are incorporating occupational report commissioned by the NHS Executive, standards into their curricula together with Utilising National Occupational Standards as a adapted assessment methodologies. However, Complement to Nursing Curricula (Storey et al these methodologies have been criticized by Le 1995), outlines ways in which three nurse Var (1996) who stated that 'Assessment in NVQs is education establishments (Lancashire, Sheffield considered to be unreliable and bureaucratic' (p and Portsmouth) have attempted to incorporate 85). It is interesting to note that she did not occupational standards into the c u r r i c u l u m . . : . . . . . comment on the processes adopted by many nurse The curriculum model used within the preeducation institutions to assess pre-registration registration programme of the Faculty of Health, nurse education programmes. University of Central Lancashire, is Beattie's (1987) four-fold model. Beattie suggests that there Bridging the theory-practice gap are four fundamental approaches to the task of planning a curriculum for nursing, each with its An ENB report, Assessing Competence in Nursing own particular strengths and weaknesses: and Midwifery Education (The Ace Project) (Bedford et a11993), was critical of the variety and quality The curriculum as of assessment of pre-registration nurses. These 1. A map of key subjects criticisms were addressed and the ENB has 2. A schedule of basic skills notified educational institutions that it is now a 3. A portfolio of meaningful personal experience requirement for students to produce portfolios 4. An agenda of important cultural issues. that link theory to practice. These requirements This curriculum model lent itself to the resulted from the ACE report which recommended processes that are already inherent incorporation of management and information in NVQ assessment; these include the following: technology NVQs into the pre-registration diploma programme (Storey et al 1995). In • The assessment of clinical practice should applying these principles to the development of require the collection of a range of forms of the management and information technology of evidence to serve as the basis for the curriculum, we had to balance current and student-assessor discussion about knowledge, future employment needs with the statutory skills, attitudes and understanding requirements of the United Kingdom Central • The preparation of clinical area assessors Council for Nursing, Midwifery & Health Visiting should develop assessors' competence in (UKCC) and the English National Board for collecting evidence, analysing data and Nursing, Midwifery & Health Visiting (ENB). developing frameworks for discussion In May 1986, the UKCC published its • Assessment documentation should be proposals for the reform of nursing education broadened to include evidence contributed by under the title Project 2000 - A new Preparation for more than one accredited witness. Practice, the principle aim being to prepare The NHS Executive shares concerns about the registered practitioners to be competent to assess theory-practice gap, and has issued a number of the need for care, and able to provide that care in a •
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Functional analysis and occupadona/ standards
Executive Letters (ELs) in relation to NVQs and occupational standards. EL(95)96, Non Medical
Education and Training Planning Guidance for 1996/97 (DOH 1995), suggested that there was a need 'to enhance links between, professional, academic and vocational education and training systems through the education commissioning process.., this moves the service towards a common understanding and dialogue about the nature, purposes and outcomes of education and training. Also about credit accumulation and transfer between and access to different qualifications and qualification systems.., to encourage the integration of Occupational Standards within new and existing courses and education programmes.., leading to a closer match between education provision and service requirements'. It went on to suggest that 'Occupational Standards and the qualifications related to them are increasingly being developed to determine and enhance the skills of a range of staff groups in the NHS' (DOH 1995).
Academia and vocationalism: creating partiy In the current climate of change within education and employment, we should be looking to combine the best aspects of higher education and vocational systems to provide programmes that meet academic, professional and vocational requirements, developing practitioners who have the potential to become lifelong learners (Storey et a11995, Parker 1996). The Higher Education Quality Council (HEQC) suggests that curricula could be designed to provide the underlying knowledge and understanding required by NVQs, work practice would be assessed by NVQawarding body assessors, and higher education would be responsible for developing reflective practice and professional capability (HEQC 1995). This option seems to offer the best of both worlds and could address the concerns expressed by Le Var (1996). The approach suggested by the HEQC may satisfy exponents of each system and could be achieved through the use of what may be termed as an 'interactive essay'; this approach has already been adopted witl~n higher education. The postgraduate diploma in higher education, a teaching qualification developed by the Staff and Education Development Association, is based on a
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modular curriculum which has been developed using a functional analysis approach. The guidelines to the programme state that 'Candidates need to be able to meet each element of competence in full on the basis of evidence relating to their activity in the classroom'; in addition, 'each module has a requirement of 5,000 words devoted to statements referring to evidence and to evaluation and reflective comment'. This approach enables candidates to use work-based evidence, relate it to the theories of learning and demonstrate how the theories have been applied in practice.
Curriculum design issues Functional analysis and curriculum development need to be inextricably linked if education is to produce students who are 'fit for purpose' and 'fit for practice' at the end of a study programme. The Department for Education and Employment (DEE) has recognized this need and has produced a series of papers (DEE 1995) aimed at increasing the integration of vocational and academic requirements within programmes of learning. Through the use of functional analysis and its outcomes, educators can develop a curriculum that reflects the needs of each sector, therefore increasing the uptake of students in part-time programmes and reducing the move towards employer-led training programmes (Rhodes & Charlton 1996). Within the National Health Service there are a number of initiatives that are using the functional analysis approach with the intention of developing a curriculum to support personal and professional development. These include the following: • Ashworth Hospital Authority and the University of Central Lancashire are developing a framework of Occupational Standards for social therapy provision for patients who have personality disorders (Storey et a11997) • The Royal Liverpool University Hospitals Trustl: is developing a framework of standards to describe clinical nursing practice and to establish what impact occupational standards for nurses would have on clinical supervision, care pathways, contracts and skill mix, identification of educational needs to inform educational consortium purchasing, identification of PREP requirements (O'Hanlon & Andrews 1996, p 25)
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@ Functional analysis and occupational standards
• North Manchester Trust is identifying and developing occupational standards for intensive care staff. This project is attempting to match occupational standards that already exist with the role of nursing staff in intensive care, and it will also identify and fill gaps in the standards structure • Norfolk and Norwich NHS Trust is extending the scope of the original NHS Executive study on utilizing national occupational standards in nursing curricula by demonstrating how standards might be used (Edwards 1996, p 6). There are also a number of projects funded by the NHS Executive that have developed or are developing draft standards in the following professional areas: • Professions allied to medicine - Physiotherapy - Occupational therapy - Speech and language therapy Dietetics - Podiatry - Radiography • Health promotion • Complementary therapies - Aromatherapy - Homeopathy - Hypnotherapy - Reflexology - Medicine -
These examples are demonstrating that the process of functional analysis can be beneficial in the development of curricula for personal and professional development, and that its use should enhance the prospects of students undertaking programmes of learning. Through the use of functional analysis, educators can address the needs of individuals and society as outlined by Gillian Shephard, Secretary of State for Education and Employment, when announcing the Committee of Enquiry into Higher Education. Today's graduates face a different world from their predecessors. They must be prepared for changes in the nature of work and the greater demands it makes. Increasingly, they will need to switch career more than once in their lifetime. We must ensure that they are equipped with_the skills and flexibility needed by the labour market of the 21st century through both initial education and updating
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and upskilling throughout their lives. Higher education must be in the best shape possible to meet these needs... As the pace of change quickens, there will be a greater premium on the capacity to innovate... HE can help too to drive local and regional regeneration through services to employers. (Shephard 1996)
Conclusion Educational programmes within higher education are designed to produce graduates who have the capability to become competent practitioners. They instil knowledge, skills and understanding in the students, but will fail to meet the needs of employment if another dimension is missing. That dimension is application. If students cannot apply their knowledge, skills and understanding in the workplace then education is failing to meet market need. The use of functional analysis and occupational standards in curriculum development can assist in overcoming this problem, leading to the development of practitioners who are not only fit for purpose but also fit for practice. Developments in occupational standards at professional levels in health care appear to undermine the concerns expressed above. Nursing has been remiss in distancing itself from competence developments within the educational and employment sectors, and is once again demonstrating 'professional preciousness'. Nursing is renowned for its inability to define its own future, and is being led by other agendas. We risk failing to capitalize on an opportunity to influence the occupational standards agenda: their integration into health care must be underpinned by a knowledge of the diverse nature of the nursing repertoire. This failure to explore ways of developing educational programmes that reflect current best practice balanced with realistic future expectations has been criticized by both purchasing authorities and policymakers alike (Storey et a11995, p 89). References
BeattieA 1987Making a curriculum work. In: Allen P,Jolly M (eds)The curriculum in nursing education. Croom Helm, London BeaumontG 1996Review of 100 NVQs/SVQs.NCVQ/SCOTVEC, London
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Functional analysis and occupational standards
Bedford H, Phillips T, RobinsonJ, Schostak J 1993 Assessing competencies in nursing and midwifery education (the Ace Project). ENB, London Clark J 1993 The future of nurse education. Report of the RCN consensus conference, September 1993. Royal College of Nursing, London Confederation of British Industry 1994 Quality assessed The CBI review of NVQs, and SVQs. CBI, London Conroy M 1996 The future healthcare workface. HSMU, Manchester University Day M, Basford L 1993 Occupational competence and capability as a complement to professional preparation: an assessment strategy for a Project 2000 nurse training programme. Sheffield & North Trent College of Nursing and Midwifery and University of Sheffield Dearing R 1996 Review of qualifications for 16-19 year olds. SCAA, London Department for Education and Employment 1995 HE projects, Briefing Paper. DEE, Sheffield Department of Health 1989 Caring for people. DOH, London Department of Health 1991 The patient's charter. DOH, London Department of Health 1992 The health of the nation. DOH, London Department of Health 1993A vision for the future. DOH, London Department of Health 1994 Nursing, midwifery and health visiting education: a statement of strategic intent. DOH, London Department of Health 1995 EL(95)96- Non medical education and training planning guidance for 1996/97. DOH, London Department of Health 1996 Primary care - the future. DOH, London Dymott S 1994 Speech to RCN Society of Occupational Health Nursing, annual conference. Nursing Standard 8(12): 7 Eaton A 1994 Taken further to task over NVQs. Letter. Nursing Standard 12(8): 41 Edwards C 1996 Within the framework. IHSM network 3(14): 6 Employment Department 1993 Knowledge and understanding: its place in relation to NVQs and SVQs. Competence and Assessment Briefing Series, December 1993
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Employment Department 1993A vision for higher level NVQs. Employment Department, Sheffield Eraut M, Cole G 1993 Assessing competence in the professions. Research and Development Series, report no. 14. Department of Employment, Sheffield Higher Education Quality Council 1995 Vocational qualifications and standards in focus. HEQC, London Jessup J 1991 Outcomes: NVQs and the emerging model of education and training. Falmer Press, London, p27 Le Var R M H 1996 NVQs in nursing, midwifery and health visiting: a question of assessment and learning. Nurse Education Today 16~-2):85-93 Mansfield R, Mitchell L 1996 Towards a competent workforce. Gower, London National Council for Vocational Qualifications 1989 The NVQ criteria and related guidance. NCVQ, London Oakes J 1994 There's no need to envy NVQs. Letter. Nursing Standard 8(16): 40-41 O'Hanlon M, Andrews D 1996 Occupational standards. Nursing Management 3(5): 24-26 Parker S 1996 Do competence based approaches have a place in higher education? NVQ higher level competence and academic knowledge: are they compatible. Conference Proceedings, UACE, Leeds, p39 Rhodes G, Charlton J 1996 Where do NVQs fit into universities?Conference Proceedings, UACE, Leeds Shephard G 1996 Announcementto the House of Commons when establishing the Committee of Enquiry into Higher Education, February 1996 Storey L, Greenham S, Martin E 1995 NVQs as part of the pre-registration diploma. Nursing Times 91(7): 34-35 Storey L, O'Kell S, Day M 1995 Utilising national occupational standards as a complement to nursing curricula. NHS Executive, Leeds Storey L, Dale C, Martin M 1997 Social therapy - A developing mode of care. NT Research, May 1997 United Kingdom Central Council for Nursing Midwifery & Health Visiting 1986 Project 2000 - A new preparation for practice, UKCC, London UniversitiesAssociation for ContinuingEducation 1996 The purposes of continuingeducation. Conference Proceedings, UACE, Leeds Wolf A 1994 Assessing the broad skills within occupational competence. Competence & Assessment 25:3-6
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11
Background
Les Storey RGN, MSc, PGDipHE, Dip Training
Management, Senior Lecturer, University of Central Lancashire,Ormskirk Campus, Ormskirk DGH, Wigan Road, Ormskirk L39 2AZ, UK
Since the advent of National Vocational Qualifications (NVQs) within health and social care, the response to methodologies used in their development has been diverse: some professionals and academics have disregarded their relevance, whilst others have embraced the concepts and have integrated aspects of best practice from both the academic and vocational approaches into personal and professional development educational programmes. Functional analysis is a process that underpins the development of occupational standards, and subsequently, NVQs. Functional analysis is a holistic, systems-based analysis approach used to analyse whole occupations in terms of outcomes and the purpose of work activities rather than specific activities, procedures and methods. This approach is used to facilitate the development of national occupational standards which are presented in the form of a functional map (a sample of a functional map of the trade union sector is shown in the Figure). Jessup (1991), in his description of functional analysis, stated that 'The analysis and specification of competence according to functions, which is now advocated, provides a
O1998HarcourtBrace&Co. Ltd
broader conception of competence than earlier task analysis approaches. The concentration on function shifts the focus of competence from tasks and procedures to the purpose and outcome of work activity' (Jessup 1991, p 27). National occupational standards define the level of performance required for the successful achievement of work expectations. They specify best practice in an employment sector and are expressed in the form of elements of competence, performance criteria and range indicators. The range indicators are used as specifications for assessment when standards are aggregated together to form qualifications. NVQs are qualifications based on standards developed through the process of functional analysis. NVQs are a selection of units of competence from a set of occupational standards endorsed by the employment sector's lead body, which meet criteria laid down by the National Council for Vocational Qualifications (NCVQ) now the Qualification and Curriculum Authority (QCA). Functional analysis gives educational providers a holistic view of the employment needs of an occupational area and enables them to develop a curriculum that reflects these needs. The outcome of functional analysis is a functional map, which outlines the key purpose, key areas
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Functional analysis and occupational standards
Key purpose: Protect, maintain and imp~ve the coll~5ve and indlvidual employmen~ ¢ondi~ons, employment opportun~ies, status ~ d social well-being of membe~ ~ defned through the decision-making proc~ses of trade unions
A Contribute to the s~mte&ic direction of trade unions and the fo~ation ~ d imp]emenc~ion of ~rade union policy
A~
InBuenceand contribute to the po~icymaking p r o x i e s and the s~te~ie di~cdon of ~ade unions
ALl AI.2 AI3 AI,4 AI,5
Iden:ify and ~ l u a : e signTfic~t sod~J ~ d economlc fac~o~ which affect the fu~u~ de~lopmen: of t~de ~nio~ Develop and propose a ~dslon~ d strategi~ for the future direction of :he t fade unions
Developandadv]~onpo[icyor/donsthatmeetiden~fiedp~orit~dsU'ategies Develop s y s ~ s and processes for the implementation ~ d monitoring of policy derisions
P~videinformat[on~d~dvicetoenableothe~tointerpret~dfollowpolicydecisiom
A2.[ Summadze,cl~ify~dpfforit[zedec~sionsmzdebypofcyrnakinBbedi~ A2.2 Advisegovern~ngbedi~onc~eriaforthep~oritT~onofpolicyoptions
A2
Suppol~ govern~r~, bodies in the interpretatlon and implementation of t~ade union policy
A3
Support the poIicyrnaking proc~s~ of trade unions
51
Rep~ent ~ d promote the ~mageand policies of t~de unions
5L I BL2 BI,3 BI.4
B2
Support acciviri~ and c~m5algns within the polid~ of I~ade uniom
B2.1 Propose, develop & implement strategies ~ d policies ~or the politi~l direction ~ d ~ctMt[es of trade unio~ B2.2 Pl~andmonitortheimplementa:ionofpol]ticalactiv~tiesandcamp~gns B2.3 Co~tdbete to acti~c~es~ d campaiB~
c~
Deve[op, organize~dcontBbutetothe recruitment and ~tendon of t~de union members
cl.I CI.2 Cl.3 Cl.d Cl,5
Developarecru~mentand~tentionst;ate ~' A~dse ~ r~ruitment and retentio~ Identify and contact potenti~ m ~ b e ~ Prepere ~ d pr~ent promotional irdormafion to po~enti~Jmembe~ Establish, maintain and monltor membe~hip information systems
C2
Develop recognition r~hts with employe~
C2.1 C2.2 C2,3 C2.4
Id~dfy ~ d make contact with employe~ Negotiate bargalnff~ r ghts v~th e mptoye~
A~3
Evaluate the cost ~ d added value of proposals ~ d decisio~
A2.4 Develop~dpropo~ope~tlonaIplansf~implemendngdecisio~ A3,1 Provide info~aBon and ath4ceto e~ble others to formulate, interfim~ and follow policy decisions A3,2 Enable membe~ to formulate, interpret ~ d foIIow policy decisions
A3.3 DevelopsystemsforobmJningandevalu~tingf~dbackfrornmembe~
_.__•
5 Represent and p~mote the image, policies ~ d purpose of trade unions
~
C Develop ~ d orgar=izethe membe~hip ~ d rep~enta:ive structures of trade unions
•_•D
C3,1 C3.2 C3.3 C3.4 C3.5
Ran ~ d monitor the development of l~al org~i~t~on Promote ~ d enlist sufipor~ for prlonty collec~ve bargaining issues Deve~op ~ d p romote a workplace coIlecBve berthing agenda Provide resources ~ d ~d~ce ~o develop systems ~ d strategies
OI
Contribute to the negotiation of terms and renditions of ~rade union membe~
DI.I DI.2 DI.3 D[.4 DL5 DI,6 DI.7
Ob~a~n,lnterp~etandsumm~a~zelnformation:osupportnegoBatio~ Ad~iseontheconductandstrategyofnegoti~tio~
D2.1 D2.2 D2.3 D2.4 D2,5
Advbeonthev~hdityandcr~dibif~yof~es Provide info~a:ion and ~ o u r c ~ to enable othe~ to p ~ p a ~ ~ e ~ P~pare ~ for p~ent~:ion and m p ~ s ~ t [ o n P~t ~ to employe~
D3.[ D3,2 D3.3 D3.d
Pro~ideirfformation~dadvicetomembe~onh~[th,~fetyandwelfarematters Investigate~dreportonpotendalh~dsintheworkplace I~tigate~dreportonthe~usesofaccidentsandinddents Contdbutemtherep~entat~onofthehe~dth,safety~dwelfa~inte~stsofmembers Develop ~d implement new member se~ic~ Monitor and improve the quality of se~ice delivery
D2
Representtheindiv[dualandcollective
inte~tsoft~deunio~membe~
Monitorandimpmvethebeabh,~fety~d
Contribete to negod~t[ng teams Refer ~ e s to ~ndii~tion and ~bit~tion services Ewdu~te ~ d p r ~ s the acceptance of offers and agreements Finali~ ~ d r~ord aB~emen~ Contffbute to the ~ l u t i o n of industrial dispu~
Presentc~to]ega[IyconsUtutedadjudicaBngbodies
Develop and provide se~ices for trade union membe~
E I. I Eh2
B2
Commi~ion se~ic~ that meet the needs of ~ d e unlon membe~
52. I Set standards and spociBcat~onsfor the prov~slonof member se~ic~ E2,2 I d e n ~ and select suppliers of member sewiees E2.3 Support ~ d ad~se supplie~ on the implementation of member se~i~s E2.40btalnandfe~dbackinform~tioninser~cequality E2.5 Contribute to ~he improvement of ser~ce delh/ery
E3
Provide spedafi~ irdormaBon and advice to colle~ues ~ d membe~
Standards from the Advice, Guidance ~ d Counselling Lead Body, plus specialist Imowledge ~ d skills appropriate to the sp~iallsm
Develop ~ d provide services to ~rade u~ion membe~
Contribute to effecdve admlnist ~tion and communication systems
Promote,supportandadviseonp~;dcip~t~vestmctur~andpmce~
EI
£ 4 0 b ~ J n and provide information and acMce to tr'ode union membe~
. ~ G
Rep~ntun~onpollcyandmemberinte~ts
Oeve~op l~ade union o rg~iz~Bo n
welf~eoftradeunionmembe~
•_•F
Prep~e and p~sent irdormadon on b r o a d ~ t media
C3
P~tect and imbrue the employment conditions of trade union members
Promoteopportuni~ for the achievement of equaTity~ d personal development
Developpolid~andguideHnesfornation~J~ndintemaBona~representadon
Maintalncontactwithemp~oye~dpromotethebeneBtsof~cognition P~momtheindustri~lreladonsbeneBtsofco[lectiveaB~emen:stoemploye~andmembe~ C2.5 PL~n~dmon~orthedeve~opmentofconsultath~estructur~dprocedur~
D3
_•IE
D~elop, implement ~ d e~luate pmmoponal st~ $ e ~ ~ d policies
f i 4 , 1 0 b m l n , pt~vTdeand int~pr~t informatio~ about unionsendces E4.2 Presentinfo~Bontogroupsofmembe~ E4.3 SUBportandad~semembe~onmatte~ofper~na[coneern
Promote equafd' of opportunity for all t~de union mBmbers
FI.I Promote the elimination of discrimination F 1,2 ~onKor and report o~ the progr~s of eq~[ opportunity policies and initi~t~v~
F2
Contribute to po~o~l and team development
F2,] Identify and select pe~onal ~du~tion and development programmes B2.2 Setpr[oritiesandmonitortheallocationofresources F2,3 Establish and main:~n effectivet ~ relationships with : ~ membe~
G[
Contributetotheeff~tlveadminist~tion of t~de unions
G[.I Inidateandm~nt~Jnorga~fzational[nformaBonandcontaetne~orks GI.2 Lead ~nform~l meetings and 5mup discussio~ to solve p~blems ~ d mzke derisions G I 3 0 r g - , m i z e and ~rvFce meetings and committ~s Gh4 Chairand~portontheprogr~s~dou~com~offo~almee~ings GI.5 Present information to mee~ngs G I . 6 0 ~ g i n a t e and r~pond to written corresponden~ GI.7 P,~cord~ d store iofo~ation
G2
Estab[ish~dmai~inporson~d communications
G2.[ Init~at~dmalnt~dnper~nallnformadon~dcon~ctnet~rks G2.2 Select and adapt ~ i t t ~ materials
G3
Provide administrative suppor: se~ic~ to t~de union, their staff and membe~ (Standards and Qual~:ion~ from the Administr~tNe Lead Body)
HI
Cont~bute ~othe fin~cial n~n~gemen~ of trade unions ~u~dtheir assets(St~dards and QualiBcaBons from the Accounting Lead Body)
H2
~nitiat~andim~Iemen~h~5e~nse~ces~dsystems(Uni~M[~/~r~mtheManagementC~armr~nitiat~vefitandards)
H3
Mon~tor,maint~n ~ d improve ser'Ace delivery (Unit HII/2 from the M~aBement Charter Inidatlve 5tand~ds)
H4
M~n[t~r~dc~ntr~theu~ofr~u~(UnitM~/3fr~mtheManagementCh~r~er~ndia~veStandards)
145 A~cate r~u~es f~r a~iviB~ and pr~i~ts (Unit M~I/4fr~mthe M~gement Char~er~n~ti~BveSt~d~ds) H Contribute to the eff~tive management of t~ade union operations
]-16 Esmb~ish and malnt~ n poI]cies for the r~mitment of staff (Un~ MII/5 from the Management Charter Initiative S:~dards) H7
Deve~p~e~s~indMdua~sand~ f t~en~anceperf~rmance(Un~tM~/6fr~mthe Man~ementCharter]nhiadveStandards)
H5
P~an'a~ocate~deva~uatew~rkcarr~ed~utbyteams'ind1vidualsandse~f(UnitMH/7fr~mthe~an~ementCharter~n~tia~veStandards)
H9 Cr~teandmainmine~ectiveworkin~re~at~nshEps(Un~cM~8fr~mtheMan~ementC~a~er~nida~veStandards ) H I0 Seek, evaluate 2nd organize infor~Bon for action(Unit MII/9 from the Management Charter In~iaUveStandards) H I I Exchange ~nformadon to solve problems and m~ke dedsiom (Unit MI[/I 0 from the M~agement Charter ~nitia=iveStandards) P~pared for the Trade Union Sector Developmer~ Body by PRIME R~earch ~ d DeveIoBment Ltd November 1995,
Figure A functional map of the trade union sector.
4
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Functional analysis and occupational standards
and key roles that are required to provide a service to patients. A functional map is normally symbolized as a 'fallen tree' (as in the Figure), which illustrates the stages of analysis and disaggregation that result in the development of occupational standards. Occupational standards are statements of competence; national specifications for performance, which include the ability to perform in a range of work-related activities. With the underpinning skills, knowledge and understanding required, they describe what should happen in employment (NCVQ 1989, Mansfield & Mitchell 1996). Functional analysis suffers from inappropriate links to 'functionalism', a 1960s approach to the description and analysis of social action. It also suffers from claims of 'reductionism, mechanistic, conforming, resistant to change and deterministic' (Mansfield & Mitchell 1996, p 99) which stems from the analytical approach used to determine occupational standards. Mansfield & Mitchell (1996, p 101) report that functional analysis has its origins in the hermeneutic and dialectical traditions of social science, relating to the social theories and methodologies of interpretative understanding, which reject the reductionist and behaviourist approaches that attempted to define and analyse social action using empirical methods adopted by the natural sciences. They go on to say that functional analysis was developed 'for the sole purpose of developing descriptions of human capability.., by concentrating on the expectations of employment, broken down through a process of structured analysis which eventually produces a level of detail which we describe as an occupational standard' (Mansfield & Mitchell 1996, p 101).
Functional analysis: the process Functional analysis determines the key purpose of an occupational area through consultation with the job holders (experts). The analysis identifies current best practice and balances these against realistic future expectations. The key purpose and key roles of the occupation are determined by asking practitioners simple, but searching, questions, such as: • What are you seeking to achieve? • What are the expected outcomes of your work?
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• What are the values that underpin and ~:ensio~s that impinge on your delivery of care? From the responses, analysts are able to produce a 'map' of the occupational area, which includes key purpose and key roles. Key roles are then broken up into subsets of units n~tade up o:f performance standards. It is this process of breaking up or disaggregating a role that alarms many educationalists. Dymott (1994) supports this view by stating that NVQs could result in nursing becoming a deskilled and mechanistic profession. However, Oakes (1994), Eaton (1994), Storey et al (1995) and Mansfield & Mitchell (1996) argue that the adoption of NVQs and the use of occupational standards does not necessarily lead to task orientation (or mechanistic practice). Wolf (1994, p 3) points out that the process ef defining standards in terms of units, elements, performance criteria and range statements, means that what is integrated in reality is often disaggregated in the assessment specification for an NVQ. However, as Mansfield & Mitchell (~996, p 127) point out it is important to keep occupational standards and NVQs separate. NVQs are but one of the ways in which occupational standards may be used. Occupational standards can be used in a variety o~ ways: to define job descriptions; to provide a benchmark for individual and organizational development; as a means of assessment of performance; as a tool for training needs analysis; and to form qualifications.
Specificity of standards A contentious issue in discussions about standards concerns the optimum level of specificity. If there is too little specificity, the result may be a lack of clarity, poor communication and diminished credibility. On the other hand, too much specificity can lead to standards that take too long to read, are cumbersome and can lead to abuse of the sys~tem by people taking short cuts. This criticism has been directed at the national occupational standards from certain occupational areas, although it is accepted that different parts of thee same set of occupational standards may requiire different levels of specificity (Eraut & Cole 1993, CBI 1994, Beaumont 1996).
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i
Functional analysis and occupational standards
If one role of standards is to establish a reasonable level of agreement and common understanding about the definition of competence, it is true that well defined standards will do this more effectively than poorly defined standards. It must be recognized, though, that there are limits to what written standards can achieve on their own. Total uniformity of interpretation is an unattainable goal. The formulation of standards involves a great deal of professional judgement. The variations in work role and working practice between one job and another within an occupational area can be quite large. It is important that standards are based on a thorough analysis of the nature of professional work and its knowledge base. There should also be an assumption that some capacity for change should be built into the standards themselves in order to ensure that students and professionals are not judged by out-of-date criteria, and that there is a clear statement of the methodology and rationale used to derive the standards which should be documented in an explicit way (Eraut & Cole 1993, p 25). Functional analysis does this, in that the outcome of the analysis is a functional map which outlines the key purpose, key roles and functions of the occupational area.
The use of occupational standards As previously described, occupational standards can be used in a number of ways, one of which is in qualifications, commonly NVQs. NVQs describe what an individual can do: they are national, and cannot be adapted to meet employment requirements in the way that occupational standards can. The requirement that candidates must provide evidence of having met the performance criteria for each element within an NVQ has led to some assessors believing that separate assessment is required for each performance criterion to ensure competence. This approach can adversely fragment teaching and learning and is at odds with the development of 'breadth' of competence. Complex and integrated tasks need an element of broad assessment that takes into account the overall quality of work as well as the ability of the students to reflect and adapt their practice. The Employment Department (1993) points out that the essential knowledge and understanding
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that underpin performance should be specified within occupational standards and highlights that, in general the higher the level of NVQ, the greater will be the proportion of evidence drawn from knowledge and understanding. Incorporating occupational standards into programmes of learning enables the students to not only demonstrate their skills, knowledge and understanding, but also to apply them in the context of their work settings. NVQs have established their position in the framework of qualifications within the UK. This has been reinforced by the Dearing report (1996), which equated a level 3 NVQ to an 'A' level within a national framework of awards. However, there is still reluctance to embrace NVQs at higher professional levels, although many professionals are starting to incorporate occupational standards into their diploma and degree programmes, e.g. Social Work and Professions Allied to Medicine. Higher education has already recognized the potential of NVQs: a survey (HEQC 1995, p 22) shows that 48 universities and 4 higher education colleges have been accredited to offer NVQs. In particular, the Vocational Qualifications Unit of the Open University has pathways that allow for both vocational and academic accreditation of programmes. NVQs as a framework of qualifications may not be attractive to some health care professionals: this may be as a result of confusion over their currency and relevance to professional development. However, the processes, particularly functional analysis, involved in the development of national occupational standards which are fundamental to the development of the qualifications, are proving to be beneficial in the production of curricula for professional development, as demonstrated by Norfolk & Norwich (Edwards 1996, p 6) and the Royal Liverpool & Broadgreen NHS Trusts (O'Hanlon & Andrews 1996). These Trusts are just two examples of ongoing work to develop frameworks of occupational standards for continuing professional development for professions supplementary to medicine and for clinical nursing practice.
Critics" views In spite of the move to increase the uptake of this methodology within the professional arena, there
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Functiona/ analysis and occupational standards
are still critics of the processes involved. It is the process of analysis and disaggregation of functions that has been criticized by a number of authors, including Le Var (1996) and Clark (1993). They suggest that this process is failing to meet the needs of nurse education. However, what they and many others fail to acknowledge is that functional analysis has the potential to provide a means for developing curricula that meet current and future employment needs within the health care sector. Within health and social care there has been significant progress in the development of occupational standards for professionals. However, nursing appears to have dismissed the benefits and potential that can be derived from their use. In a recent article, Le Var (1996) critically examined the process of assessment associated with NVQs. She concluded that, 'On the basis of research evidence of the effects of assessment on learning, assertions have been made regarding the likely effects of the NVQ approach to assessment on learning. These effects do not match the requirements of professional education and training aimed at producing a competent practitioner' (p 87). This opinion reflects the views of other academics and professionals. Professor June Clark has stated that NVQs and occupational standards were potentially undermining professionals by reducing the qualifications required of them to a list of technical skills. Her major anxiety was that pre-registration education was slipping out of the profession's control. Another of Clark's worries was that professional education for nursing would gradually replaced by employer-led vocational training: 'a step back of more than 50 years' (Clark 1993, p 7). She also pointed out that preparation for nursing needs an intellectually stimulating, research-oriented, multidisciplinary approach. 'The socialisation process of the present vocational training system militates heavily against the creativity and intellectual curiosity.., required for research and adaptability" (Clark 1993, p 7). These views demonstrate a lack of understanding of the processes involved in the development and implementation of national occupational standards, and fail to acknowledge the changing needs of health care and education.
Educating the future workforce It is accepted that a skilled and knowledgeable workforce is essential to achieving many of the
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strategic objectives highlighted by a variety of policy documents and reports, including Caring for People (DOH 1989), The Patient's Charter (DOH 1991), The Health of the Nation (DOH 1992), A Vision for the Future (DOH 1993), The Future Hedth Care Workforce (Conroy 1996) and Primary Care The Future (DOH 1996). Education and training for health care professionals has to take account of these and future policy changes if they wish to produce the competent and relevantly educated practitioners of the future. It is essential that the products of nursing faculties and departments in higher education are viewed as 'fit for purpose', whilst also perceived as providing 'value for money'. This view is highlighted by the Department of Health (1994) in its statement of strategic intent for the nursing, midwifery and health visiting professions, and in recent executive letters, for example EL(95)96 (DOH 1995), where the use of occupational standards in educational programmes is advocated.
Occupational standards and professional development Approaches to the integration of occupational standards within higher education have been attempted in a number of institutions. The conference proceedings from the Universities Association for Continuing Education (1996) record a number of initiatives where occupational standards and traditional higher education processes are being merged. One paper in particular (Parker 1996, p 39) reflected on experiences of using NVQs in higher education and the comparability between professional curricula in higher education and NVQs. In spite of inherent differences between the models, several ways of integrating the two approaches were suggested. These included: • The incorporation of NVQ units accredited within higher education curricula. This would[ involve linking pure knowledge (higher education focus) with competence (NVQ focus) by assessing understanding in the workplace • The development of portfolios of NVQs at levels 4 and 5 after obtaining a university certificate or diploma.
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Functional analysis and occupational standards
Recognition that management lends itself to NVQ awards, but that there are difficulties with other disciplines. • Progression can be built into NVQ achievement, but only in terms of closing the gap between an individual's present and desired future performance (Parker 1996, p 39).
range of institutional and non-institutional settings (UKCC 1986). Day & Basford (1993) point out that since the inception of Project 2000, commentators have questioned the ability of nurse education programmes to achieve the desired outcome of a 'knowledgeable doer'. They report that some people view Project 2000 students as lacking competence and confidence, compared with Occupational standards and the students who have undertaken traditional nurse pre-registration curriculum education and training programmes. In an attempt In certain respects, these models of integration of to address this perceived imbalance, many higher occupational standards have already been education institutions offering nursing attempted within nurse education programmes. A programmes are incorporating occupational report commissioned by the NHS Executive, standards into their curricula together with Utilising National Occupational Standards as a adapted assessment methodologies. However, Complement to Nursing Curricula (Storey et al these methodologies have been criticized by Le 1995), outlines ways in which three nurse Var (1996) who stated that 'Assessment in NVQs is education establishments (Lancashire, Sheffield considered to be unreliable and bureaucratic' (p and Portsmouth) have attempted to incorporate 85). It is interesting to note that she did not occupational standards into the c u r r i c u l u m . . : . . . . . comment on the processes adopted by many nurse The curriculum model used within the preeducation institutions to assess pre-registration registration programme of the Faculty of Health, nurse education programmes. University of Central Lancashire, is Beattie's (1987) four-fold model. Beattie suggests that there Bridging the theory-practice gap are four fundamental approaches to the task of planning a curriculum for nursing, each with its An ENB report, Assessing Competence in Nursing own particular strengths and weaknesses: and Midwifery Education (The Ace Project) (Bedford et a11993), was critical of the variety and quality The curriculum as of assessment of pre-registration nurses. These 1. A map of key subjects criticisms were addressed and the ENB has 2. A schedule of basic skills notified educational institutions that it is now a 3. A portfolio of meaningful personal experience requirement for students to produce portfolios 4. An agenda of important cultural issues. that link theory to practice. These requirements This curriculum model lent itself to the resulted from the ACE report which recommended processes that are already inherent incorporation of management and information in NVQ assessment; these include the following: technology NVQs into the pre-registration diploma programme (Storey et al 1995). In • The assessment of clinical practice should applying these principles to the development of require the collection of a range of forms of the management and information technology of evidence to serve as the basis for the curriculum, we had to balance current and student-assessor discussion about knowledge, future employment needs with the statutory skills, attitudes and understanding requirements of the United Kingdom Central • The preparation of clinical area assessors Council for Nursing, Midwifery & Health Visiting should develop assessors' competence in (UKCC) and the English National Board for collecting evidence, analysing data and Nursing, Midwifery & Health Visiting (ENB). developing frameworks for discussion In May 1986, the UKCC published its • Assessment documentation should be proposals for the reform of nursing education broadened to include evidence contributed by under the title Project 2000 - A new Preparation for more than one accredited witness. Practice, the principle aim being to prepare The NHS Executive shares concerns about the registered practitioners to be competent to assess theory-practice gap, and has issued a number of the need for care, and able to provide that care in a •
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Executive Letters (ELs) in relation to NVQs and occupational standards. EL(95)96, Non Medical
Education and Training Planning Guidance for 1996/97 (DOH 1995), suggested that there was a need 'to enhance links between, professional, academic and vocational education and training systems through the education commissioning process.., this moves the service towards a common understanding and dialogue about the nature, purposes and outcomes of education and training. Also about credit accumulation and transfer between and access to different qualifications and qualification systems.., to encourage the integration of Occupational Standards within new and existing courses and education programmes.., leading to a closer match between education provision and service requirements'. It went on to suggest that 'Occupational Standards and the qualifications related to them are increasingly being developed to determine and enhance the skills of a range of staff groups in the NHS' (DOH 1995).
Academia and vocationalism: creating partiy In the current climate of change within education and employment, we should be looking to combine the best aspects of higher education and vocational systems to provide programmes that meet academic, professional and vocational requirements, developing practitioners who have the potential to become lifelong learners (Storey et a11995, Parker 1996). The Higher Education Quality Council (HEQC) suggests that curricula could be designed to provide the underlying knowledge and understanding required by NVQs, work practice would be assessed by NVQawarding body assessors, and higher education would be responsible for developing reflective practice and professional capability (HEQC 1995). This option seems to offer the best of both worlds and could address the concerns expressed by Le Var (1996). The approach suggested by the HEQC may satisfy exponents of each system and could be achieved through the use of what may be termed as an 'interactive essay'; this approach has already been adopted witl~n higher education. The postgraduate diploma in higher education, a teaching qualification developed by the Staff and Education Development Association, is based on a
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modular curriculum which has been developed using a functional analysis approach. The guidelines to the programme state that 'Candidates need to be able to meet each element of competence in full on the basis of evidence relating to their activity in the classroom'; in addition, 'each module has a requirement of 5,000 words devoted to statements referring to evidence and to evaluation and reflective comment'. This approach enables candidates to use work-based evidence, relate it to the theories of learning and demonstrate how the theories have been applied in practice.
Curriculum design issues Functional analysis and curriculum development need to be inextricably linked if education is to produce students who are 'fit for purpose' and 'fit for practice' at the end of a study programme. The Department for Education and Employment (DEE) has recognized this need and has produced a series of papers (DEE 1995) aimed at increasing the integration of vocational and academic requirements within programmes of learning. Through the use of functional analysis and its outcomes, educators can develop a curriculum that reflects the needs of each sector, therefore increasing the uptake of students in part-time programmes and reducing the move towards employer-led training programmes (Rhodes & Charlton 1996). Within the National Health Service there are a number of initiatives that are using the functional analysis approach with the intention of developing a curriculum to support personal and professional development. These include the following: • Ashworth Hospital Authority and the University of Central Lancashire are developing a framework of Occupational Standards for social therapy provision for patients who have personality disorders (Storey et a11997) • The Royal Liverpool University Hospitals Trustl: is developing a framework of standards to describe clinical nursing practice and to establish what impact occupational standards for nurses would have on clinical supervision, care pathways, contracts and skill mix, identification of educational needs to inform educational consortium purchasing, identification of PREP requirements (O'Hanlon & Andrews 1996, p 25)
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• North Manchester Trust is identifying and developing occupational standards for intensive care staff. This project is attempting to match occupational standards that already exist with the role of nursing staff in intensive care, and it will also identify and fill gaps in the standards structure • Norfolk and Norwich NHS Trust is extending the scope of the original NHS Executive study on utilizing national occupational standards in nursing curricula by demonstrating how standards might be used (Edwards 1996, p 6). There are also a number of projects funded by the NHS Executive that have developed or are developing draft standards in the following professional areas: • Professions allied to medicine - Physiotherapy - Occupational therapy - Speech and language therapy Dietetics - Podiatry - Radiography • Health promotion • Complementary therapies - Aromatherapy - Homeopathy - Hypnotherapy - Reflexology - Medicine -
These examples are demonstrating that the process of functional analysis can be beneficial in the development of curricula for personal and professional development, and that its use should enhance the prospects of students undertaking programmes of learning. Through the use of functional analysis, educators can address the needs of individuals and society as outlined by Gillian Shephard, Secretary of State for Education and Employment, when announcing the Committee of Enquiry into Higher Education. Today's graduates face a different world from their predecessors. They must be prepared for changes in the nature of work and the greater demands it makes. Increasingly, they will need to switch career more than once in their lifetime. We must ensure that they are equipped with_the skills and flexibility needed by the labour market of the 21st century through both initial education and updating
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and upskilling throughout their lives. Higher education must be in the best shape possible to meet these needs... As the pace of change quickens, there will be a greater premium on the capacity to innovate... HE can help too to drive local and regional regeneration through services to employers. (Shephard 1996)
Conclusion Educational programmes within higher education are designed to produce graduates who have the capability to become competent practitioners. They instil knowledge, skills and understanding in the students, but will fail to meet the needs of employment if another dimension is missing. That dimension is application. If students cannot apply their knowledge, skills and understanding in the workplace then education is failing to meet market need. The use of functional analysis and occupational standards in curriculum development can assist in overcoming this problem, leading to the development of practitioners who are not only fit for purpose but also fit for practice. Developments in occupational standards at professional levels in health care appear to undermine the concerns expressed above. Nursing has been remiss in distancing itself from competence developments within the educational and employment sectors, and is once again demonstrating 'professional preciousness'. Nursing is renowned for its inability to define its own future, and is being led by other agendas. We risk failing to capitalize on an opportunity to influence the occupational standards agenda: their integration into health care must be underpinned by a knowledge of the diverse nature of the nursing repertoire. This failure to explore ways of developing educational programmes that reflect current best practice balanced with realistic future expectations has been criticized by both purchasing authorities and policymakers alike (Storey et a11995, p 89). References
BeattieA 1987Making a curriculum work. In: Allen P,Jolly M (eds)The curriculum in nursing education. Croom Helm, London BeaumontG 1996Review of 100 NVQs/SVQs.NCVQ/SCOTVEC, London
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Bedford H, Phillips T, RobinsonJ, Schostak J 1993 Assessing competencies in nursing and midwifery education (the Ace Project). ENB, London Clark J 1993 The future of nurse education. Report of the RCN consensus conference, September 1993. Royal College of Nursing, London Confederation of British Industry 1994 Quality assessed The CBI review of NVQs, and SVQs. CBI, London Conroy M 1996 The future healthcare workface. HSMU, Manchester University Day M, Basford L 1993 Occupational competence and capability as a complement to professional preparation: an assessment strategy for a Project 2000 nurse training programme. Sheffield & North Trent College of Nursing and Midwifery and University of Sheffield Dearing R 1996 Review of qualifications for 16-19 year olds. SCAA, London Department for Education and Employment 1995 HE projects, Briefing Paper. DEE, Sheffield Department of Health 1989 Caring for people. DOH, London Department of Health 1991 The patient's charter. DOH, London Department of Health 1992 The health of the nation. DOH, London Department of Health 1993A vision for the future. DOH, London Department of Health 1994 Nursing, midwifery and health visiting education: a statement of strategic intent. DOH, London Department of Health 1995 EL(95)96- Non medical education and training planning guidance for 1996/97. DOH, London Department of Health 1996 Primary care - the future. DOH, London Dymott S 1994 Speech to RCN Society of Occupational Health Nursing, annual conference. Nursing Standard 8(12): 7 Eaton A 1994 Taken further to task over NVQs. Letter. Nursing Standard 12(8): 41 Edwards C 1996 Within the framework. IHSM network 3(14): 6 Employment Department 1993 Knowledge and understanding: its place in relation to NVQs and SVQs. Competence and Assessment Briefing Series, December 1993
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Employment Department 1993A vision for higher level NVQs. Employment Department, Sheffield Eraut M, Cole G 1993 Assessing competence in the professions. Research and Development Series, report no. 14. Department of Employment, Sheffield Higher Education Quality Council 1995 Vocational qualifications and standards in focus. HEQC, London Jessup J 1991 Outcomes: NVQs and the emerging model of education and training. Falmer Press, London, p27 Le Var R M H 1996 NVQs in nursing, midwifery and health visiting: a question of assessment and learning. Nurse Education Today 16~-2):85-93 Mansfield R, Mitchell L 1996 Towards a competent workforce. Gower, London National Council for Vocational Qualifications 1989 The NVQ criteria and related guidance. NCVQ, London Oakes J 1994 There's no need to envy NVQs. Letter. Nursing Standard 8(16): 40-41 O'Hanlon M, Andrews D 1996 Occupational standards. Nursing Management 3(5): 24-26 Parker S 1996 Do competence based approaches have a place in higher education? NVQ higher level competence and academic knowledge: are they compatible. Conference Proceedings, UACE, Leeds, p39 Rhodes G, Charlton J 1996 Where do NVQs fit into universities?Conference Proceedings, UACE, Leeds Shephard G 1996 Announcementto the House of Commons when establishing the Committee of Enquiry into Higher Education, February 1996 Storey L, Greenham S, Martin E 1995 NVQs as part of the pre-registration diploma. Nursing Times 91(7): 34-35 Storey L, O'Kell S, Day M 1995 Utilising national occupational standards as a complement to nursing curricula. NHS Executive, Leeds Storey L, Dale C, Martin M 1997 Social therapy - A developing mode of care. NT Research, May 1997 United Kingdom Central Council for Nursing Midwifery & Health Visiting 1986 Project 2000 - A new preparation for practice, UKCC, London UniversitiesAssociation for ContinuingEducation 1996 The purposes of continuingeducation. Conference Proceedings, UACE, Leeds Wolf A 1994 Assessing the broad skills within occupational competence. Competence & Assessment 25:3-6
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