3.3 Current skills and competencies

To capture the Digital Rehabilitation skills and competencies of rehabilitation professionals working clinically in Kenya, Tanzania and Rwanda, we created a self-assessment based on the European Digital Competence Framework for Citizens (DigComp 2.2) [5] as part of the landscape analysis in the RADIC project. In the following, we are explaining the self-assessment, give insights in the results and the derived recommendations to enhance the competencies. If you want to read the whole report of the landscape analysis, please follow the link (coming soon). 

The self-assessment for rehabilitation professionals consisted of two parts: 

Part 1: Demographic profile including sex, age, education level, working experience and the setting type (rural or urban).

Part 2: Digital competency questions adopted from the European Digital Competence Framework for Citizens (DigComp2.2) which has twenty-one items divided into five major components including information and data literacy, content creating, communication, safety, and problem solving. In the following, we are presenting the definitions of the five components. The DigComp is a descriptive, enabling framework designed to support the development of digital competence of individuals personally and professionally. All items were measured in 5-point Likert scale ranging from strongly disagree (score 0) to strongly agree (score 4). See for the complete self-assessment the appendix.

Information and data literacy:

Information and data literacy understand the competency level of participants focused majorly on individual’s ability to search, find, appraise, sort, store and retrieve information using digital devices.

Digital content creation: 

Digital content creation describes an individual’s ability to create/delete/manipulate contents such as text and images in different application software such as Microsoft Word and Excel in digital devices. It also includes adjusting settings based on one’s interest of use.

Communication and collaboration:

Communication and collaboration focuses on an individual’s capability to communicate, share, and interact with others using digital devices and network. It includes internet or local area connections.

Safety & Security:

Safety & Security assesses what people do to protect their devices from cyber/physical attack and the precautions they take on their own health. 

Problem solving: 

Problem solving focuses on assessing the skill of individual’s potential in solving routine hardware and software problems encountered while using digital devices. Problem solving also evaluates where a person stops working when difficulties appear, or they look for digital solutions.

3.3.1. Analysis 

The results of the participants were classified into different categories based on their overall scores. The DigComp 2.2 has 21 items (maximum score is 84). The Newcomer (A1) category is attributed to scores below 19, the Explorer category (A1) to scores between 19 and 32 (this upper limit corresponding to half of the items selected being "partial appropriation" and the other half "occasional use"); scores between 33 and 47 are mapped on the Integrator category; scores between 48 and 62 on the Expert (B2) category, thus splitting in equal halves the distance between the upper limit of the Explorer (A2) category and the lower limit of the Leader (C1) category. Scores between 63 and 76 are attributed to the Leader (C1) level. Scores between 77 and 84 are attributed to the Pioneers (C2).

3.3.2. Results 

The survey was carried out in 2024 in Tanzania, Rwanda and Kenya. In total 174 rehabilitation professionals (physiotherapists, occupational therapists, speech therapists, psychologists, prosthetics and orthotics) answered the survey. The majority of the participants were physiotherapists (62,1%). In table 2, we present the overall results of the self-assessment per component of the DigComp 2.2. 

Table 2: Overall results of the self-assessment per domain of the DigComp 2.2

Table 3 shows the scoring of participants per level.

Table 3: Frequencies of levels within the results of the self-assessment

3.3.3. Discussion

The results indicate that a significant portion of rehabilitation professionals, both in clinical or community settings, scored above the threshold considered to be indicative of expertise, leadership, or pioneering status in the field of digital competencies. In clinical or community settings, 65.5% of professionals scored above 47, with 40.8% categorized as experts, 18.4% as leaders, and 6.3% as pioneers. These findings suggest that a significant proportion of rehabilitation professionals possess advanced knowledge and skills related to Digital Rehabilitation, regardless of whether they work in clinical/community or academic settings. The high percentages of experts and leaders in both settings suggest a strong foundation of expertise and leadership within the field, which bodes well for the advancement and implementation of Digital Rehabilitation interventions in practice. However, it's worth noting that the digital competencies were self-reported.

Self-rating surveys, while valuable tools for gathering subjective data, have several limitations that should be considered while interpreting the survey results: 

• Social desirability bias: Respondents may provide answers that they believe are socially acceptable or desirable, rather than reflecting their true opinions or behaviors. This can lead to inaccurate or biased results, particularly if respondents feel pressured to present themselves in a positive light. 
• Lack of objectivity: Self-rating surveys rely on individuals' perceptions of themselves, which may not always align with objective reality. Factors such as self-esteem, mood, and cognitive biases can influence respondents' self-assessments, leading to inaccuracies or inconsistencies in the data. 
• Limited insight into unconscious biases: Respondents may be unaware of their own biases or may underreport socially undesirable traits or behaviors. This can result in incomplete or misleading information, particularly when assessing sensitive topics or traits. 
• Variability in interpretation: Self-rating scales may be interpreted differently by different individuals, leading to variability in responses. This can make it difficult to compare results across respondents or to draw meaningful conclusions from the data. 
• Inability to capture complex behaviors or experiences: Self-rating surveys typically rely on simplified Likert scales or other rating systems, which may not fully capture the complexity of individuals' experiences, attitudes, or behaviors. This can limit the depth of insight gained from the data and may overlook important nuances or subtleties. 
• Limited generalizability: Self-rating surveys are often based on convenience samples of respondents, which may 

3.3.4. Recommendations 

To enhance the digital competencies of rehabilitation professionals in East Africa, it's essential to involve key stakeholders and collaborate on strategic initiatives. Here are some recommendations tailored to different stakeholders: 

Government Bodies and Regulatory Agencies: 

• Develop policies and regulations that encourage the integration of digital technologies into rehabilitation practices. 
• Invest in improving ICT infrastructure to ensure widespread access to digital tools and resources. This includes providing adequate internet connectivity, computers, and technical support services to facilitate seamless integration of technology in education. 
• Provide funding and resources for training programs focused on digital competencies for rehabilitation professionals. 
• Establish standards and accreditation processes for digital tools used in rehabilitation to ensure quality and safety. 

Institutions of Higher Education (HEIs) in East Africa

• Enhanced Digital Literacy Programs: Institutions of Higher Education (HEIs) in East Africa should prioritize the development of digital literacy programs for both educators and students. These programs should focus on enhancing digital competence across various domains, including information literacy, communication skills, digital content creation, and safety. 
• Update curricula to include courses on digital technologies relevant to rehabilitation practice, such as telehealth, electronic health records, and assistive technologies. 
• Provide faculty development opportunities to ensure educators are equipped to teach digital competencies effectively. 
• Offer hands-on training opportunities, such as clinical placements or internships, where students can apply their digital skills in real-world settings. 

Professional Associations and Organizations:

• Offer continuing education programs and workshops specifically designed to enhance digital competencies. 
• Facilitate networking opportunities for rehabilitation professionals to share best practices and learn from each other's experiences with digital technologies. 
• Advocate for the inclusion of digital competency requirements in professional certification and licensure processes. 

Technology Developers and Industry Partners:

• Collaborate with rehabilitation professionals to co-design and tailor digital tools to meet their specific needs and preferences. 
• Provide training and technical support to ensure rehabilitation professionals can effectively use and integrate digital technologies into their practice. 
• Offer affordable pricing models or subsidies for digital solutions to make them more accessible to rehabilitation facilities in East Africa. 

Healthcare Facilities and Employers:

• Invest in infrastructure upgrades, such as reliable internet connectivity and secure data storage systems, to support the adoption of digital technologies. 
• Provide incentives, such as bonuses or professional development opportunities, to encourage rehabilitation professionals to enhance their digital competencies. 
• Foster a culture of innovation and continuous learning within the organization to promote the uptake of digital tools and practices. 

Researchers

• Continuous monitoring and research efforts are essential to keep pace with the rapidly evolving digital landscape. Researchers should collaborate with policymakers to conduct longitudinal studies and evaluate the effectiveness of digital pedagogy initiatives in rehabilitation education. 

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