Legislation/Policies to increase the flexibility of Professional Higher Education in the health sector

 

This case study responds to a long-term issue in Romania, concerning the recognition of non-formal or informal professional competences, but with regard to a specific field. More exactly, in the past 25 years in Romania, there have been successive changes of the levels of initial education programs for nurses, in addition to the coexistence of different types of training programs for this profession: post-secondary schools, colleges and university programs. Thus, on the labor market, there are nurses with post-secondary education and nurses who graduated from university programs of short or long duration (3 or 4 years). They share the same job duties but receive different levels of pay as a consequence of different educational background.

Nevertheless, the main problem resides in the fact that in order to advance in their career, post-secondary trained nurses need to start the educational process again, with another form of initial education. Thus, there have been nurses that have been obliged to attend several forms of education in order to maintain their profession at the initial level. The total duration of education sometimes is longer than the duration for the training of a physician (STUDY: Echivalarea asistentelor medicale absolvente postliceală – formă de acțiune împotriva discriminării [Equivalence of medical assistants with post-secondary degrees], p. 56, in Some forms of health care employees discrimination; conceptual approaches and legal solutions, Good Practice Guide, Rotilă Viorel (coord.), Sodalitas, 2015).

It is estimated that over 50.000 medical assistants (including midwifes) did not attend a higher level
education program because during their professional training, such programs were not available.
The problem also relates to the conditions that the nurses must meet in order to perform
professional activities in another EU member state, as regulated by the Professional Qualifications Directive 2005/36/CE amended by the Directive 2013/55/EU.

The response to the aforementioned issues consisted in the EU-funded project Methodological framework on recognition and equivalence of formal, non-formal or informal professional competences by medical assistants who did not attend university level education programs POSDRU/155/1.2/S/141134.  The beneficiaries of the project were the Ministry of Education and Research, and the National Institute of Infectious Diseases “Matei Balş” (as partener).

The goal of the project was to enhance competence-based higher education through the development of a methodological framework for the recognition of the prior professional competences in formal, non-formal and informal contexts by nurses who did not attend higher education. The specific objectives of the project include: 1. Promoting life-long learning and expanding learning opportunities through the creation and dissemination of a unitary national framework recognition of prior professional competences in formal, non-formal and informal contexts by nurses who did not attend higher education, with the end goal of increasing their employability and international mobility. 2. The creation of an e-learning system and the set up of a multimedia classroom for training purposes of the target group. 3. standardizing the curricula and the training design for the target group, and conducting technology assisted education.

The project, which had a duration of 18 months (04/01/2014 – 09/30/2015), has reached its objective, setting the framework for the recognition of the professional competences for potentially over 50.000 medical assistants who did not attend a university program.

The main results of the project include: a Guide of Good Practice, a methodological framework aiming at facilitating recognition and equivalence of professional competences, and interactive courses for health professionals.


More Information

Impact

What was the challenge intended to be addressed? Why? What did work well? What did not work well? What have been the main achievements? How did you evaluate its success? What has been the change brought by this good practice?

Over 50.000 medical assistants who did not attend a university program now benefit from a framework of recognition of their professional competencies.
Also, art. 174, para (6) of Law no. 1/2011 (Education Law) has recently been modified by the Parliament, repealing the article that has blocked so far the transfer of credits from the post-secondary level to university level programs for the medical sector. The new law also regulates the partial recognition of professional competences by transferable credits in the European credit transfer system (ECTS) and the possibility of completing the professional training to the same level as medical assistants with a university degree. The changes were formally accepted and published in the Official Monitor in April 2017.

Success Factors

What are the enabling conditions (e.g. institutional, economic, social/cultural, regulatory) that needed to be in place or played a facilitating role for the good practice to be successful?

The main success factor of the project is the participation of the Ministry of Education as the main beneficiary. Any major initiatives in the field of education reform must have the support of regulators, central authorities and policy makers.

Constraints

What are the challenges, barriers or limiting factors encountered? How have they been addressed?

The broad range of stakeholders involved in this process required significant logistics efforts. One of the outcomes of the project - the revision of the legal framework involved further procedural constraints. These challenges have been addressed by co-opting various stakeholders as partners though a EU-funded project.

Feasibility & Sustainability

What are the elements that need to be put into place for the good practice to be sustainable (institutionally, socially, economically, etc.)? If applicable, indicate the total costs incurred for the implementation of the practice. What are the benefits compared to total costs?

For the implementation of the methodological framework, 90 experienced teaching staff have been selected from six Universities of Medicine and Pharmacy. They have been trained within the project in order to develop the new structures that would organize the recognition of the formal, non-formal and informal competences in their own institutions.

Replicability & Upscaling

What are the possibilities of extending the good practice more widely? What are the conditions that need to be in place for the good practice to be successfully replicated in a similar context? What are the steps that should be taken/respected to ensure that the good practice is replicated / up-scaled, but adapted to the new context?

The framework is the basis of the future structures from accredited universities that organize graduate programs for medical assistants for the recognition and equivalence of competences.
The approach can set an example for other professions in which workers need eased access form post-secondary to higher education (e.g. technicians in various fields).

Lessons learned

What would have facilitated an earlier and/or bigger impact? What are the key features that should be kept in mind if this would have to be implemented again? What would you do differently if you could go back in time? What could have been done better?

The legal and normative frameworks relevant for professional education needs the flexibility to harmonize the heterogeneity of the labor markets and to adapt to its changes.
There is an increased need to recognize informal and non-formal education for professionals, as employers already look for candidates with competences acquired in prior professional settings, besides educational ones.

Context

Please provide some information about the context and initial situation that can help in fully understanding the action (e.g. information about the national system, applying regulations, etc.)

In the past 25 years in Romania, there have been successive changes of the levels of initial education programs for nurses, in addition to the coexistence of different types of training programs for this profession: post-secondary schools, colleges and university programs. Thus, on the labor market, there are nurses with post-secondary education and nurses that graduated from university programs of short or long duration (3 or 4 years). They share the same job duties but receive different levels of pay. The problem also relates to the conditions that the nurses must meet in order to perform professional activities in another EU member state, as regulated by the Professional Qualifications Directive 2005/36/CE amended by the Directive 2013/55/EU.