Educational programmes have also proven to impact on practitioners' competences [ 29, 30].
BECCI was developed to evaluate practitioner competence in using BCC in controlled trials.
Study of the fidelity of intervention delivery comprised evaluation of practitioner competence (not performance) in simulated consultations before the onset of the study and again five to seven months later.
Challenges included uncertainty about guidance specifying face to face notification; how best to balance allaying parental anxiety by using familiar non-specialist health professionals with concerns about practitioner competence; and extent of information parents should be given.
While support for non-specialists giving results was consistent, informants were uncertain about how best to balance allaying parental anxiety by using a non-specialist and concerns about practitioner competence.
In terms of its educational function, the study has implications for defining professional standards, designing training programs and ongoing professional development requirements, developing professional learning theory, and improving practitioner competence and client outcomes.
Practitioners should consider using competence frameworks from the relevant treatment manuals, and for all interventions they should: -Receive regular, high quality supervision -Use routine outcome measures and involve the person with depression in reviewing treatment efficacy -Monitor and evaluate adherence to treatment and practitioner competence.
And bring parents up because it can come out of the blue can't it, they don't even know anything about it and then you're telling them that there's something wrong with their perfect baby.' (CHC 08) Although confident that this task was within a non-specialist remit, participants noted concerns about practitioner competence.
Implementation of clear role boundaries might go some way towards ensuring that nursing care does not exceed the limits of practitioner competence, thereby managing risk; it would also facilitate the annual performance assessment, by providing clear benchmark statements against which to measure performance and through which future CPD needs can be identified and met.
While there is evidence of the need for pre-hospital practitioners maintaining competence in other ambulance services internationally e.g., Australia, UK and Canada, their guidelines are less prescriptive.
