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The development of competency frameworks in healthcare professions: a scoping review

Abstract

Competency frameworks serve various roles including outlining characteristics of a competent workforce, facilitating mobility, and analysing or assessing expertise. Given these roles and their relevance in the health professions, we sought to understand the methods and strategies used in the development of existing competency frameworks. We applied the Arksey and O’Malley framework to undertake this scoping review. We searched six electronic databases (MEDLINE, CINAHL, PsycINFO, EMBASE, Scopus, and ERIC) and three grey literature sources (greylit.org, Trove and Google Scholar) using keywords related to competency frameworks. We screened studies for inclusion by title and abstract, and we included studies of any type that described the development of a competency framework in a healthcare profession. Two reviewers independently extracted data including study characteristics. Data synthesis was both quantitative and qualitative. Among 5710 citations, we selected 190 for analysis. The majority of studies were conducted in medicine and nursing professions. Literature reviews and group techniques were conducted in 116 studies each (61%), and 85 (45%) outlined some form of stakeholder deliberation. We observed a significant degree of diversity in methodological strategies, inconsistent adherence to existing guidance on the selection of methods, who was involved, and based on the variation we observed in timeframes, combination, function, application and reporting of methods and strategies, there is no apparent gold standard or standardised approach to competency framework development. We observed significant variation within the conduct and reporting of the competency framework development process. While some variation can be expected given the differences across and within professions, our results suggest there is some difficulty in determining whether methods were fit-for-purpose, and therefore in making determinations regarding the appropriateness of the development process. This uncertainty may unwillingly create and legitimise uncertain or artificial outcomes. There is a need for improved guidance in the process for developing and reporting competency frameworks.

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Source: Moher et al. (2009)

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Acknowledgements

The authors wish to thank Ms. Paula Todd and Ms. Megan Anderson for their valuable insights into the search strategy.

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Correspondence to Alan M. Batt.

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Appendices

Appendix 1

See Table 7, 8.

Table 7 Search terms, dates, and number of results by database
Table 8 Search terms, dates, and number of results—grey literature resources

Appendix 2

See Table 9.

Table 9 Coding template with example

Appendix 3: Citations for included studies

Ablah, E., Biberman, D. A., Weist, E. M., Buekens, P., Bentley, M. E., Burke, D., et al. (2014). Improving global health education: Development of a global health competency model. American Journal of Tropical Medicine and Hygiene, 90(3), 560–565. https://doi.org/10.4269/ajtmh.13-0537.

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Alfieri, E., Alebbi, A., Bedini, M. G., Boni, L., & Foà, C. (2017). Mapping the nursing competences in neonatology: a qualitative research. Acta bio-medica : Atenei Parmensis, 88(3–S), 51–58. https://doi.org/10.23750/abm.v88i3-s.6614.

Ali, A. M. (2012). Pharmacist prescribing in the Australian context: development and validation of competency standards and identification of pharmacists’ educational needs. Monash University. Retrieved from https://trove.nla.gov.au/work/186453738.

AlShammari, T., Jennings, P. A., & Williams, B. (2018). Emergency medical services core competencies: A scoping review. Health Professions Education. https://doi.org/10.1016/j.hpe.2018.03.009.

Ambuel, B., Trent, K., Lenahan, P., Cronholm, P., Downing, D., Jelley, M., et al. (2011). Competencies Needed by Health Professionals for Addressing Exposure to Violence and Abuse in Patient Care. Eden Prairie, MN.

Amendola, M. L. (2008). An examination of the leadership competency requirements of nurse leaders in healthcare information technology. ProQuest Information & Learning US, US. Retrieved from http://media.proquest.com/media/pq/classic/doc/1674957421/fmt/ai/rep/NPDF?hl=information,information,for,for,nurses,nurse,nurses,nurse&cit:auth=Amendola,+Mark+Lawrence.

Anderson, R. O. (2016). Assessing Nurse Manager Competencies in a Military Hospital. ProQuest Dissertations and Theses. ProQuest Information & Learning US, US. Retrieved from http://primo-pmtna01.hosted.exlibrisgroup.com/openurl/01WMU/01WMU_SERVICES??url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&genr.

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Blanchette, L. (2015). An exploratory study of the role of the organization and the… ProQuest Information & Learning US, US. Retrieved from http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=psyc13a&NEWS=N&AN=2016-17339-289.

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Cappiello, J., Levi, A., & Nothnagle, M. (2016). Core competencies in sexual and reproductive health for the interprofessional primary care team. Contraception, 93(5), 438–445. https://doi.org/10.1016/j.contraception.2015.12.013.

Carraccio, C., Englander, R., Gilhooly, J., Mink, R., Hofkosh, D., Barone, M. A., & Holmboe, E. S. (2017). Building a Framework of Entrustable Professional Activities, Supported by Competencies and Milestones, to Bridge the Educational Continuum. Academic medicine : journal of the Association of American Medical Colleges, 92(3), 324–330. doi:https://dx.doi.org/10.1097/ACM.0000000000001141.

Carrico, R. M., Rebmann, T., English, J. F., Mackey, J., & Cronin, S. N. (2008). Infection prevention and control competencies for hospital-based health care personnel. American Journal of Infection Control, 36(10), 691–701. https://doi.org/10.1016/j.ajic.2008.05.017.

Carrington, C., Weir, J., & Smith, P. (2011). The development of a competency framework for pharmacists providing cancer services. Journal of Oncology Pharmacy Practice, 17(3), 168–178. https://doi.org/10.1177/1078155210365582.

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Chan, B., Englander, H., Kent, K., Desai, S., Obley, A., Harmon, D., & Kansagara, D. (2014). Transitioning Toward Competency: A Resident-Faculty Collaborative Approach to Developing a Transitions of Care EPA in an Internal Medicine Residency Program. Journal of Graduate Medical Education, 6(4), 760–764. https://doi.org/10.4300/jgme-d-13-00414.1.

Chang, A., Bowen, J. L., Buranosky, R. A., Frankel, R. M., Ghosh, N., Rosenblum, M. J., et al. (2013). Transforming primary care training - Patient-centered medical home entrustable professional activities for internal medicine residents. Journal of General Internal Medicine, 28(6), 801–809. https://doi.org/10.1007/s11606-012-2193-3.

Chen, S. P., Krupa, T., Lysaght, R., McCay, E., & Piat, M. (2013). The development of recovery competencies for in-patient mental health providers working with people with serious mental Illness. Administration and Policy in Mental Health and Mental Health Services Research, 40(2), 96–116. https://doi.org/10.1007/s10488-011-0380-x.

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Appendix 4

See Table 10.

Table 10 Characteristics of included studies

Appendix 5

See Table 11.

Table 11 Rationale by profession

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Batt, A.M., Tavares, W. & Williams, B. The development of competency frameworks in healthcare professions: a scoping review. Adv in Health Sci Educ (2019) doi:10.1007/s10459-019-09946-w

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Keywords

  • Professional competence
  • Clinical competence
  • Competency development