Year of Award

2022

Document Type

Dissertation

Degree Type

Doctor of Philosophy (PhD)

Degree Name

Public Health

Department or School/College

School of Public and Community Health Sciences

Committee Chair

Catherine Off

Commitee Members

Cindi Laukes, Tony Ward, Gilbert Quintero, Rich Bridges

Keywords

interdisciplinary approaches, licensure oversight, Montana healthcare, standards of care, state licensing boards, traumatic brain injury

Publisher

University of Montana

Abstract

Introduction: State licensing boards (SLBs) serve as overseers to protect the interests of the public by ensuring that individuals who operate under a license to practice in a state uphold the standards of their profession. However, resolving complaints regarding unprofessional conduct for conditions that necessitate interdisciplinary care, such as traumatic brain injury (TBI), may necessitate involvement from SLBs of other disciplines who are most qualified to evaluate the appropriateness of care. To date, there is no single pathway to address complaints regarding the interdisciplinary management of TBI as the mechanisms of the injury are complex, often do not address the full spectrum of issues, and can only address the actions of one clinician at a time. The potential creation of a stand-alone, state-level, interdisciplinary TBI-related oversight board comprised of members from six existing TBI-specific Montana SLBs (TBI-SLB) was explored to understand, overcome, and provide a single pathway for complaint resolution in Montana TBI licensure oversight.

Methodology: A mix-method, parallel convergent design was used for the study. Two independent studies were conducted: one qualitative, comprised of interviews (N=26) with two groups of federal-level clinicians and researchers to gauge feasibility of creating a TBI-SLB, and one quantitative, comprised of professional occupation licensure data collected from 2014-2019 Montana Governor’s Professional and Occupational Reports to explore fiscal burden. The results were then analyzed in a third triangulation data integration study through a side-by-side comparison.

Results:

Qualitative: Interview response data indicated three primary categories areas of interest after descriptive analysis: (1) Standards, (2) Fiscal Concerns, and (3) Scope/Oversight.

Quantitative: Linear/multivariate regression modeling and descriptive statics showed that when combined, the proposed TBI-SLB resulted in an overall total increase in revenue and applications to practice specialized medicine and a decrease in the number of complaints.

Triangulation: With the exception of revenue, there was a lack of agreement in all areas of data explored through comparative analysis.

Conclusion: With revenue being the singular data point in agreement, the researcher cannot conclude there is justification for the creation and possible implementation of a TBI-SLB at this time. More focused research is indicated in this area.

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© Copyright 2022 Charles Robert Brown Gatlin