On Thursday, 11/17/2022, the project team welcomed over 60 participants to the first internal university annual meeting of the Sage SAGE!* project in the Audimax of ASH Berlin. The Sage SAGE! project, funded by the German Federal Ministry of Education and Research BMBF from 2021 to 2027, can look back on a busy and eventful project year.
In her welcoming speech, Pro-Rector and Co-Project Leader, Prof. Dr. Bergs-Winkels recalled the lengthy process of the project's development. Since the early conception phase, the involvement of as many university members as possible had been a core concern of the project. The broad participation of students and colleagues from administration, various departments, teaching and (junior) scientists at this annual conference was all the more gratifying.
A special focus is on the scientifically based consolidation of the therapy and nursing programs as well as on the recruitment of professional practitioners for academic careers. The colleagues of subproject 3 „Dialogue and transfer between university, professional practice and politics“ were responsible for the content, planning and implementation.
Why academization of therapy and nursing professions or of SAGE professions?
„The considerable lack of qualified professionals and the unfinished academization are societal challenges that also have to be seen in the context of the struggles for an upgrading of care and nursing work, for adequate framework conditions of professional work with people and for social infrastructure“, said Prof. Dr. Julia Franz (focus professor for research and transfer in the professional fields of social work) in her introductory lecture.
„Across Europe, Germany is the only country where therapeutic professions are not fully academized. The academization rate for occupational therapists and physiotherapists is only about 5%“, said Prof. Dr. Elke Kraus (Professor for Professionalization and Academization of the Therapy Professions), summarizing the „special features“ of the occupations of physiotherapists and occupational therapists in Germany. Under the politically introduced model clause of 2010, universities are also allowed to train therapists, but vocational training still predominates. In this context, the recently introduced training allowance means that vocational training has a considerable competitive advantage over university studies. However, the two different and contradictory educational paths end up in the same field of work and impair the quality of practice. The only way forward is full academization for all therapy professions.
It is only since 2020 that vocational and university education for the nursing professions has been regulated in a partially academized form with the Nursing Professions Act (PflBG). Prof. Dr. Katja Boguth (focus professor „Scientific foundation of a practice curriculum for nursing studies“) traced achievements and challenges of the law. It is true that only nurses who have passed vocational or university training are allowed to be responsible for the nursing process and to analyze, assure and develop the quality of nursing care. However, nursing content is not defined by law, and there is a lack of clarification of the areas of responsibility and activity for academically trained nurses.
„In social work, which is already fully academically trained, the situation is somewhat different“, as Prof. Dr. Julia Franz pointed out. Here, the focus is on efforts to create appropriate framework conditions for professional work, to establish a social infrastructure and to strive for an upgrading of the socially necessary care work. Other important questions for advancing the professionalization of the discipline relate to the generation of knowledge in a challenging interrelationship between theory and practice, as well as the need for critical use of knowledge by social work professionals.
What are the next steps of the focal professors in subproject 3 „Dialogue and transfer between university, professional practice and politics“?
Within the framework of the study program in physical and occupational therapy, conceptual variants are to be developed as to how to continue with the study programs and forms after the model clause, which is to end in 2024. In addition, curricular considerations, promotion of young scientists and science-practice-transfer are tasks of the main professor Prof. Dr. Elke Kraus. Participation in nationwide initiatives and networks for the full academization of the therapy professions as well as professional-political activities will be further deepened.
The next steps of the two focus professors Prof. Dr. Katja Boguth and Prof. Dr. Anja Dieterich in subproject 3 are, among others, the research and adapted application of international role models for modern professional role models of academically qualified nursing professionals, the development of an implementation process for the practice curriculum in academic teaching institutions of the ASH Berlin as well as to help shape professional and health policy strategies in the state of Berlin and nationwide.
For social work, Prof. Dr. Julia Franz will promote topics such as the improvement of the framework conditions in professional work, the upgrading of the social recognition of the SAGE professions and knowledge generation in social work - among other things within the framework of a „Social Work Workshop“, a low-threshold offer for social workers interested in doctoral studies and with an affinity for science.
In a „writing discussion“, the participants were able to put their suggestions, questions and thoughts on the topic on paper, which were then evaluated or followed up in a workshop.
In the panel discussion, experts from professional practice and professional associations used a case study to discuss the variety of aspects and developments in practical work. In particular, precarious working conditions, open questions of responsibility, isolated work of different professionals in the health professions were brought into focus. It became clear, for example, that different occupational groups sometimes take a similar holistic view of the person to be treated in the case study (what does he or she prioritize, what does he or she want, where does he or she most urgently need help). However, these are rarely reflected in medical diagnoses and prescriptions and thus run the risk of either not being implemented or being focused on in parallel by multiple stakeholders. In addition, it was discussed that it can sometimes make a considerable difference how well the attending specialist is trained, whether academically trained, for example, when it comes to their scope of action in treatment and the reference to evidence-based treatment. As a conclusion, it can be stated that the current structures of the physician's authority to issue directives do not always do justice to a networked, complementary and also client-centered treatment. Direct access, as discussed in the field of physiotherapy, was mentioned as an example of new trends. What developments and interactions can be discerned between these developments was discussed at this annual conference.
In two parallel workshops, participants were able to either explore diversity in nursing and health professions or deepen and structure the writing conversation. In the workshop „Diversity: (K)ein Thema in Pflege- und Gesundheitsberufen?“ Prof. Dr. Dr. Hürrem Tezcan Güntekin gave a presentation on „Diversity in Nursing. On the Necessity of Intersectionality“, in which she criticized the homogeneous depiction of age in studies as predominantly white, German, Christian, and heterosexual, as well as addressing the need for an intersectional view of those receiving care. Three foci of diversity in care were highlighted in the presentation: sexual orientation, trauma and dementia, and migration and caregiving. Often, the interweaving of characteristics leads to multiple feeling of alienation of care recipients, such as the parallel occurrence of the characteristics of age, dementia, early loss of German as a second language, and migration experience. In her conclusion, Prof. Dr. Dr. Hürrem Tezcan Güntekin emphasized the need to adopt an intersectional perspective in research, to provide diversity-sensitive care and to conduct diversity-sensitive research.
In a second lecture, Mareike Niendorf presented „selected discrimination-critical highlights“ on the topic of „Diversity in (care) institutions“. A discussion of the questions „Who do public institutions serve? Who are they geared towards? Who are they made for?“ serves as a first step in identifying institutional discrimination. Islamophobia, rejectionism, and LGBTQI+ hostility in inpatient settings were examined in more detail and supported with citations. In order to work critically on discrimination, topic-specific knowledge and concrete concepts are needed. Mareike Niendorf sees this as a perspective for the academization of the SAGE professions. Research desiderata can be worked on and critical diversity can be systematically anchored in the courses of study.
After the presentations, the participants had a lively discussion about how critical diversity can be brought into the field, that discriminatory attitudes have to be differentiated from unprofessional actions due to overload, and that demarcation or mutual blame between the professional groups (e.g. doctors and nurses) lead to more barriers, less exchange and worse work.
The deepening of the writing conversation was well received in an interdisciplinary workshop, in which students and teachers from the different professional groups exchanged ideas. The result was a matrix in which pressing current problems, approaches to solutions, but also concerns were named for the areas of „practice“, „education“, „politics“, and „science & research.“ The challenges written in the introductory lecture were confirmed and also supplemented by the participants of the workshop. The longing for more social trust in SAGE professions and their empowerment as well as in a stronger cooperation became clear, which was not only demanded for the professional practice, but should already be reflected in the studies, for example in joint courses. Academization must also not end with the bachelor's degree; clinical master's programs for therapy and nursing studies must be offered and doctoral programs must be established. The major societal benefits that would result from full academization are particularly evident in the area of science and research. For example, evidence-based practice (EBP) enables efficient care, and the development and establishment of new fields of action for the SAGE professions can help to better close the existing and expected gaps in care and make the professions more attractive. The participants saw a danger in the fact that new hierarchies could form within the professions as a result of the academization process and that this could lead to the exclusion of non-academic members of the professions. This is also closely linked to the demands that were made of politics: Professional supervision by a self-governing body, creation of professional and continuing education regulations, investment in study programs and research, and finally, to improve the framework conditions in the study programs by financing the practical study phases and extending the standard period of study to eight semesters.
One aspect of the project is to publicly promote the academization of the relevant study programs at various levels and thus drive this forward. This is how the idea came about to develop a press kit for various representatives from politics and business, in which the arguments for academization are presented in a concentrated manner and the social benefits for society are thus made clear. Content for this folder was extracted from the writing walls in a further step of the evaluation of the writing discussion. These were collected for this purpose, clustered and then prioritized in a subsequent group discussion. Here, too, it became clear that an increase in the attractiveness of the occupational groups and thus a higher level of satisfaction in the occupational group were among the priorities.
In conclusion, the participants expressed their gratitude for being able to exchange ideas at the conference and in the workshop on an interprofessional basis beyond their own status and professional group. The encouragement, the active participation and the great interest of the participating university members in the project work strengthen the further university cooperation in the sense of the project plan.
Further information: www.ash-berlin.eu/hochschule/organisation/sage-sage/kontakt/
* The akronyms Sage SAGE stand for „Systemrelevante Akademisierung gender- und diversitygerecht etablieren“ „Soziale Arbeit, Gesundheit und Erziehung und Bildung in der Kindheit“, which translates to „Establish system-relevant academization that is gender- and diversity-responsive“ „Social work, health and education in childhood“
