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BackgroundGlobally professional accounting bodies expect of higher education institutions to develop integrated thinking skills in prospective chartered accountants. There are, however, many barriers in the way of both lecturers and students to achieve the development of integrated thinking skills.AimThis article sought to identify the most significant barriers lecturers and students face when developing integrated thinking skills in prospective chartered accountants during higher education.SettingInterviews were conducted and an online questionnaire ministered.MethodThe mixed-method approach and a pragmatist paradigm are utilised. Both questionnaires and interviews were used to collect primary data. A triangulation between the quantitative data, qualitative data, and literature had been performed.ResultsThe three most significant barriers that lecturers face in developing integrated thinking skills are the volume of technical content, lack of expertise, and large classroom sizes. The three most significant barriers that students face in developing integrated thinking skills are students being overburdened with the technical content of the syllabus, not having been exposed to integrated thinking prior to higher education, and having to study in a second language.ConclusionThe most significant barriers for both lecturers and students in the development of integrated thinking skills during the higher education of prospective chartered accountants are identified in this study.ContributionWhile much has been published on the barriers to developing integrated thinking skills, a limited amount of literature addresses the specific barriers that exist in the accounting education field.

BackgroundMany accounting professional bodies, of which the South African Institute of Chartered Accountants (SAICA) is one, expect academics to develop integrated thinking skills in their students during higher education. Integrated thinking is, however, often confused with critical thinking, systems thinking and design thinking.AimThis article aims to delineate the concept of integrated thinking by analysing the similarities and differences between integrated thinking, integrative thinking, critical thinking, systems thinking and design thinking.ConclusionIntegrated thinking is a higher-order thinking skill with a strong emphasis on the ability to think in a creative manner. Although there are differences between integrated thinking and other higher-order thinking skills, there are also similarities. This article sets integrated thinking apart from other higher-order thinking skills.ContributionLimited research has been conducted to distinguish integrated thinking from integrative thinking, critical thinking, systems thinking and design thinking. This article endeavours to identify the true nature of integrated thinking by comparing it with other higher-order thinking skills. If lecturers at higher education institutions are to develop integrated thinking skills, it is important for them to have a clear understanding of what integrated thinking is, and how it differs from other thinking models. Without a grounded understanding of what integrated thinking is, it is nearly impossible to develop it in students.

This study examines the development of integrated thinking skills during the higher education of prospective professional accountants. Due to the complexities that Industry 4.0, Industry 5.0, and COVID-19 added to the business world, increasing importance was placed on professional accountants’ ability to solve complex and ill-structured business problems in an innovative and creative manner. The ability to think in an integrated manner is crucial for professional accountants and increasingly professional accounting bodies are placing an emphasis on the development thereof. Professional accounting bodies also expect that integrated thinking is developed during the higher education of prospective professional accountants in order to close the expectation gap between what employers are expecting of new recruits and the quality of graduates that universities are delivering.By pursuing the eight objectives listed below, this study adds to the body of academic information already in existence: (1) development of a model, based on best practice and literature, to effectively develop integrated thinking skills during academic programmes presented in higher education for prospective professional accountants; (2) document the impact that Industry 4.0, Industry 5.0, and COVID-19 has had on the role of professional accountants and higher education institutions; (3) document global initiatives in higher education to develop integrated thinking skills; (4) document the definition and process of integrated thinking and analyse the similarities and differences between integrated thinking, integrative thinking, critical thinking, design thinking, and systems thinking; (5) analyse the importance of creativity for integrated thinkers and how it can be developed during higher education; (6) analyse which pedagogies South African Institute for Chartered Accountants (SAICA) accredited universities perceive to be effective in the development of integrated thinking skills and obtain insight into what they are currently doing to promote integrated thinking in their academic programmes; (7) understand what SAICA accredited universities perceive to be the barriers to developing integrated thinking skills; and (8) determine at what point integrated thinking should be introduced during higher education.A pragmatist paradigm was applied to achieve the above objectives. Qualitative as well as quantitative data were collected as primary data for analysis and interpretation. The quantitative data from the questionnaire were analysed with Statistical Package for Social Sciences (SPSS) and based on the analysis questions were developed for interview participants. From the interviews, themes were identified, and a data transformation triangulation design was applied. Secondary data for the literature review were collected from secondary publicly available data, such as journal articles (both peer reviewed and non-peer reviewed), PhD theses, Master’s dissertations, books, and websites. The primary data were collected from questionnaires and interviews which were self-administered.Based on the results of the literature, quantitative and qualitative data were collected, a model was developed that will best support the development of integrated thinking skills during the higher education of prospective professional accountants. It was further found that Industry 4.0, Industry 5.0, and COVID-19 has had a significant impact on the skillset required of professional accountants. In order to develop graduates with this new skillset, reform is required during higher education. Based on the definitions available in the literature, a definition for integrated thinking was proposed for the accounting education field. The effectiveness of several constructivist pedagogies to enable the development of integrated thinking was explored, as well as the current use thereof by SAICA accredited universities. Barriers for both lecturers and students in the development of integrated thinking skills were identified. Finally, the point of introduction of integrated thinking skills during higher education was also determined.

Disclosure: O. Abawi: None. T. Du Toit: None. G. Sommer: None. C.D. Vögel: None. M. Groessl: None. U. Halbsguth: None. S.E. Hannema: None. C. de Bruin: None. E. Charmandari: None. E.L. van den Akker: None. C.E. Flueck: None. Introduction: Treatment of children with Congenital Adrenal Hyperplasia (CAH) aims at balancing steroid replacement, hyperandrogenism and hypercortisolism. Optimal treatment and its assessment however remain a conundrum. Currently, specialists integrate clinical and conventional laboratory parameters such as 17-hydroxyprogesterone (17OHP) and androstenedione (A4). In recent years, 11-oxygenated androgens (11oxyAs) have been proposed as promising biomarkers, but their merit in treatment monitoring is not yet established. Aim: To investigate potential biomarkers of treatment quality in children with CAH by comprehensive serum steroid profiling. Methods: This prospective, observational cohort study was conducted at 4 academic pediatric endocrinology outpatient clinics and included children with genetically confirmed 21-hydroxylase deficiency. At 2 consecutive visits (mean 4.1 ± 0.7 months apart), a targeted and untargeted panel of conventional adrenal and additional peripheral steroids was analysed in serum using liquid chromatography-mass spectrometry. This included 11β-hydroxy (11OH)-androstenedione (11OHA4), 11keto-A4 (11KA4), 11OH-testosterone (11OHT), and 11keto-T (11KT). At each visit, the pediatric endocrinologist classified patients as undertreated, optimally treated or overtreated based on detailed clinical and endocrinologic evaluation, including serum 17OHP and A4 profiling. Mixed-effects logistic regression analyses on log-steroid concentrations adjusted for age, sex, BMI-z, pubertal status, CAH subtype (classic vs non-classic) and random effects for unique patients were performed to investigate odds ratios (OR) of being undertreated vs optimally treated. False discovery rate adjusted P<0.05 was considered significant. Results: We included 138 visits (86 [62%] optimal treatment, 52 [38%] undertreatment) from 72 patients, of whom 31 (43%) girls, 59 (82%) had classic CAH, and 31 (43%) were prepubertal. Mean age at first visit was 10.6 ± 5.2 years, mean BMI-z was 0.6 ± 1.1. Ten out of 17 conventional steroids, including 17OHP and 21-deoxycortisol but not A4, were associated with undertreatment. All 11oxyAs were associated with undertreatment: 11OHA4 (OR 3.64, SE 1.42, P=0.008), 11OHT (OR 2.91, SE 1.09, P=0.012), 11KT (OR 2.77, SE 1.00, P=0.01), and 11KA4 (OR 2.64, SE 0.84, P=0.009). The strongest association with undertreatment was found for the sum of 11oxyAs (OR 4.04, SE 1.70, P=0.008). Discussion: We show that 11oxyAs have the strongest association with undertreatment in children with CAH. This study supports the inclusion of 11oxyAs in the biochemical work-up of CAH to improve treatment monitoring and underscores the importance of analysing unconventional steroids in CAH by comprehensive steroid profiling. Following on, our steroid profiling can now be extended to characterise other forms of CAH and cases of suspected overtreatment. Presentation: Thursday, June 15, 2023