de Souza interprofessional practice cancer competency framework



As the demand in cancer care continues to increase, health systems require a workforce of highly educated specialists and generalists to provide continuity of care across settings.


Led by de Souza Institute in Canada, an interdisciplinary working group was formed to develop a competency framework with relevance across regulated health professionals involved in cancer care.


The working group was presented with results from a scoping review of national and international guidelines, standards, and competencies in oncology, as well as data from needs assessments on continuing education opportunities and oncology topics most relevant to clinicians. Fifty-one professionals from, e.g., family medicine, pharmacy, social work, psychology, occupational therapy, and nursing participated in seven focus groups. An additional 32 nurses participated in a nursing-specific needs assessment survey. Using modified Delphi technique, working group members conducted three iterative rounds to review data and built consensus on competency items in relation to three levels of expertise, from early learner/novice practitioner, advancing practitioner, to expert practitioner.


A final consensus was reached for the selection of competencies that reflect optimal cancer care mapped into three levels of expertise, as well as knowledge, skills, and attitudes expected of each level. Examples for the competency for early learner/novice practitioner include the following: Have awareness of common ethical issues in cancer care (knowledge); demonstrate ability to discuss, educate, and counsel patients and their support persons(s) regarding preferences (skills); and appreciate the impact of culture, the sensitivity, and diversity of attitudes in relation to cancer (attitude). Expert practitioner examples include: recognition of need for, and ability to advocate for challenges involving equity and access in order to improve health outcomes (skill) and awareness of workplace complexities, such as provider roles, team functioning, and organizational environments affecting patient-practitioner relationships (attitude).


The de Souza Interprofessional practice cancer competency framework provides a set of shared competencies and a novice to expert pathway for clinicians across disciplines and supports a more standardized learning and comprehensive approach in organizing professional development towards a coordinated, high quality, and person-centered care.

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We would like to acknowledge contributions by all external experts and stakeholders who reviewed the framework; and to physicians in the working group Dr. Pamela Catton, Dr. Kim Miller, and Dr. Caroline Gerin-Lajoie.


Funding was provided by the Ontario Ministry of Health and Long term Care.

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Correspondence to Mary Jane Esplen.

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Relevance: The manuscript describes an interprofessional practice cancer competency framework that supports person-centered oncology care across disciplines. It is therefore relevant to policy and/or programs.

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Esplen, M.J., Hunter, J., Maheu, C. et al. de Souza interprofessional practice cancer competency framework. Support Care Cancer 28, 797–808 (2020).

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  • Oncology
  • Interprofessional practice
  • Competencies and standards
  • Educational framework
  • Quality of care