Modellierung von Kompetenzen in der Telerehabilitation: Erforderliche Kompetenzen, Schulungsbedarfe und Kompetenzentwicklung in der digitalen Reha-Nachsorge in Deutschland

Background: The use of digital technology to deliver rehabilitation services – also known as telerehabilitation – offers the potential for improved continuity of care, quality of care, and patient-centeredness due to its location- and time-independent nature and the adaptability of the programs. At the same time, telerehabilitation programs place new demands on patients and therapists. If users are not adequately prepared for program usage and lack the necessary com-petencies, the success of implementation and utilization can be hindered. Against this back-ground, this dissertation aims to develop and apply a competency model for patients and the-rapists in telerehabilitation. Methods: The dissertation is based on four studies employing var-ious qualitative and quantitative research approaches that draw on the competency modeling process to identify required competencies, existing training needs, and quality requirements for competency development in telerehabilitation in Germany. It adopts an interdisciplinary per-spective on the research topic and synthesizes models and theories from health literacy, imple-mentation, and educational research that shape the conceptual understanding of competencies and competency development and serve as the theoretical foundation. Results: Patients and therapists perform a wide range of tasks related to the preparation and execution of telerehabil-itation. The required competencies are complex and can be categorized into the four dimensions of knowledge, skills, attitudes, and experience. For patients, personal interest in the program, self-awareness, self-management skills, and openness toward new things are the most relevant competencies; for therapists, these are therapeutic-professional skills, medical knowledge, and telerehabilitation knowledge. The results imply that the tasks and competencies required vary depending on the user, technology, and context, with the type of program standing out as the most important differentiating factor in patients’ assessment of the relevance of competencies. Both user groups demonstrate a moderate to high level of competency and minimal training needs regarding telerehabilitation. Patients and therapists who are less technology-affine demonstrate more and higher training needs. Therapists and patients in Germany currently have access to a variety of information and training offers. However, with regard to the identified quality requirements for competency development, current practice shows deficiencies: oppor-tunities for practical testing are lacking, and the provision of information about telerehabilita-tion in rehabilitation facilities is neither standardized nor widespread. Conclusions: The com-petent use of telerehabilitation requires appropriate user-, technology-, and context-related con-ditions. Needs-based information and training programs, the integration of telerehabilitation into therapeutic vocational training curricula, and user participation in the development of new programs can contribute to the successful application of telerehabilitation in the future