The limited existing advice and observed variability when
developing competency frameworks in healthcare professions
may lead to the creation of “false-god” frameworks that
unwittingly create and legitimise artificial outcomes.
•Competency frameworks serve many roles including
outlining characteristics of a competent workforce, to
provide clarity to complex constructs, to facilitate
professional mobility, and to help structure analysis,
evaluation or assessment of professional 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
•Arksey and O’Malley framework was applied
•Six electronic databases (MEDLINE, CINAHL, PsycINFO,
EMBASE, Scopus, and ERIC) and three grey literature
sources were searched using keywords related to
•Studies of all types were included that described the
development of a competency framework in a healthcare
•Studies were screened for inclusion, and data were
extracted independently by two reviewers.
•Data synthesis was both quantitative and qualitative.
Alan M. Batt PhD(c)1-3, Walter Tavares PhD3,4, Brett Williams PhD1
1.Dept of Paramedicine, Monash University, Australia
2.Paramedic Programs, Fanshawe College, Canada
3.McNally Project for Paramedicine Research, Canada
4.The Wilson Centre, University of Toronto, Canada
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How do healthcare professions develop competency
•Variability exists in what methods or combinations of
methods developers used as well as within methods.
•Adherence to existing guidance was inconsistent, and
existing guidelines are insufficient.
•Limited connections were made between intended use of
the framework and development choices.
•Processes and outcomes were inconsistently reported.
•These findings may result in uncertainty regarding the
utility and validity of the outcomes, which may lead to
unintended or unwarranted legitimacy i.e. “false-gods”.
•These “false-gods” may be worshipped or admired
through their influence on downstream processes such as
curriculum, policy, mobility and assessment.
•In light of our findings, improved guidance
may be required for those developing
competency frameworks in healthcare
citations, 190 were
selected for analysis.
•The majority of studies
were conducted in
medicine and nursing
were utilised in 140
were conducted in 112
(59%), and 81 (43%)
outlined some form of