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How do healthcare professions develop competency frameworks?

Authors:

Abstract

Background/Purpose Competency frameworks serve many roles including outlining characteristics of a competent workforce, facilitating professional mobility, and structuring curriculum and assessment. Given their significance in health professions, we sought to understand the strategies used in the development of existing competency frameworks. Methods We conducted a scoping review using the Arksey and O'Malley framework. Six electronic databases and three grey literature sources were searched using keywords related to competency frameworks. Studies of all types were included that described the development of a competency framework in a healthcare profession. Studies were screened for inclusion independently by two reviewers. Data synthesis was both quantitative and qualitative. Results 190 citations were selected for analysis. The majority of studies were conducted in medicine and nursing. We found a significant degree of diversity in methodological strategies, and inconsistent adherence to existing (albeit limited) guidance on framework development. Based on the variation we observed in choice, sequence, application and reporting of methods and strategies, there is no apparent standardised approach to competency framework development Conclusion Significant variation exists in the processes used to develop competency frameworks. Adherence to existing guidelines is inconsistent. This raises questions about which processes are fit for purpose and whether resulting competency frameworks capture the complexities associated with clinical practice, the value or completed frameworks to the corresponding profession, and whether existing processes lead to unintended but legitimized artificial outcomes. Guidance in competency development processes may need to be revisited
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.
INTRODUCTION
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
frameworks.
METHODS
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
competency frameworks.
Studies of all types were included that described the
development of a competency framework in a healthcare
profession.
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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published paper
How do healthcare professions develop competency
frameworks?
KEY FINDINGS
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
professions.
Competency
Framework
RESULTS
Among 5,710
citations, 190 were
selected for analysis.
The majority of studies
were conducted in
medicine and nursing
professions.
Group techniques
were utilised in 140
studies (74%),
literature reviews
were conducted in 112
(59%), and 81 (43%)
outlined some form of
stakeholder
deliberation.
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