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Proposing a re-conceptualisation of competency framework terminology for health: a scoping review.

ABSTRACT: BACKGROUND:Competency frameworks are being taken up by a growing number of sectors and for a broad range of applications. However, the topic of competency frameworks is characterised by conceptual ambiguity, misunderstanding and debate. Lack of consistency in the conceptualisation and use of key terminology creates a barrier to research and development, consensus, communication and collaboration, limiting the potential that competency frameworks have to deal with real workforce challenges. This paper aims to advance the field by conducting a detailed review of the literature to understand the underlying causes of conceptual differences and divergent views and proposing a re-conceptualisation of competency framework terminology for use by the health sector. METHODS:A broad scoping review of literature was conducted to identify publications relating to the conceptualisation of competency frameworks and key terms, examine how they are conceptualised and determine how this evolved. In addition, a purposive sample of health-related competency frameworks was chosen to illustrate how the terms and concepts are currently being applied in the health context. RESULTS:Of the 4 155 records identified, 623 underwent text searches and broad quantitative analysis, and 70 were included for qualitative analysis. Quantitative analysis identified 26 key terms, which were coded under six thematic headings. Qualitative analysis using the thematic areas revealed two distinct conceptualisations of competency frameworks and their terminology emerging concurrently in the education and employment sectors, with different underpinnings and purposes. As competency frameworks have developed, these two conceptualisations intertwined, resulting in the same terms being used to convey different concepts. Examination of health-related frameworks showed that this merging of concepts is prominent, with lack of consistency in definitions and use of key terms even within a single organisation. DISCUSSION AND CONCLUSIONS:Building on previous efforts to address the lack of conceptual clarity surrounding competency frameworks, this paper proposes a re-conceptualisation of the terminology that encompasses two distinct competency framework interpretations, using a glossary of mutually exclusive terms to differentiate concepts. The re-conceptualisation holds relevance for multiple competency framework applications within health, enabling harmonisation, clear communication, consensus-building and effective implementation of competency frameworks.

SUBMITTER: Mills JA

PROVIDER: S-EPMC7035756 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Proposing a re-conceptualisation of competency framework terminology for health: a scoping review.

Mills Jody-Anne JA Middleton James W JW Schafer Alison A Fitzpatrick Siobhan S Short Stephanie S Cieza Alarcos A

Human resources for health 20200221 1

<h4>Background</h4>Competency frameworks are being taken up by a growing number of sectors and for a broad range of applications. However, the topic of competency frameworks is characterised by conceptual ambiguity, misunderstanding and debate. Lack of consistency in the conceptualisation and use of key terminology creates a barrier to research and development, consensus, communication and collaboration, limiting the potential that competency frameworks have to deal with real workforce challenge ...[more]

PMID: 32085739

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Project description:Addressing health workforce cultural competence is a common approach to improving health service quality for culturally and ethnically diverse groups. Research evidence in this area is primarily focused on cultural competency training and its effects on practitioners' knowledge, attitudes, skills and behaviour. While improvements in measures of healthcare practitioner cultural competency and other healthcare outcomes have been reported, there are concerns around evidence strength and quality. This scoping review reports on the intervention strategies, outcomes, and measures of included studies with the purpose of informing the implementation and evaluation of future interventions to improve health workforce cultural competence.This systematic scoping review was completed as part of a larger systematic literature search conducted on cultural competence intervention evaluations in health care in Canada, the United States, Australia and New Zealand published from 2006 to 2015. Overall, 64 studies on cultural competency interventions were found, with 16 aimed directly at the health workforce.There was significant heterogeneity in workforce intervention strategies, measures and outcomes reported across studies making comparisons of intervention effects difficult. The two main workforce intervention strategies identified were cultural competency training and other professional development interventions including other training and mentoring. Positive outcomes were commonly reported for improved practitioner knowledge (9/16), skills (7/16), and attitudes/beliefs (5/16). Although health care (6/16) and health (2/16) outcomes were reported in some studies there was very limited evidence of positive intervention impacts. Only four studies utilised existing validated measurement tools to assess intervention outcomes.Training and development of the health workforce remain a principle strategy towards the goal of improved cultural competence in health services and systems. Diverse approaches are available to increase health workforce cultural competence. However, the effects of interventions beyond practitioner knowledge and attitudes remains unclear. Assessment of practitioner behavioural outcomes as well as measures of intervention impact on healthcare and health outcomes are needed to build a stronger evidence base.

Project description:Competencies ensure public health students and professionals have the necessary knowledge, skills, values, and behaviours to do their jobs effectively. Public health is a dynamic and complex field requiring robust competency statements and frameworks that are regularly renewed. Many countries have public health competencies, but there has been no evidence synthesis on how these are developed. Our research aim was to synthesize the extent and nature of the literature on approaches and best practices for competencies statement and framework development in the context of public health, including identifying the relevant literature on approaches for developing competency statements and frameworks for public health students and professionals using a scoping review; and, synthesizing and describing approaches and best practices for developing public health competency statements and frameworks using a thematic analysis of the literature identified by the scoping review. We conducted a scoping review and thematic analysis of the academic and grey literature to synthesize and describe approaches and best practices for developing public health competency statements and frameworks. A systematic search of six databases uncovered 13 articles for inclusion. To scope the literature, articles were assessed for characteristics including study aim, design, methods, key results, gaps, and future research recommendations. Most included articles were peer-reviewed journal articles, used qualitative or mixed method design, and were focused on general, rather than specialist, public health practitioners. Thematic analysis resulted in the generation of six analytical themes that describe the multi-method approaches utilized in developing competency statements and frameworks including literature reviews, expert consultation, and consensus-building. There was variability in the transparency of competency framework development, with challenges balancing foundational and discipline-specific competencies. Governance, and intersectoral and interdisciplinary competency, are needed to address complex public health issues. Understanding approaches and best practices for competency statement and framework development will support future evidence-informed iterations of public health competencies.

Project description:IntroductionLearning in the clinical setting is a major form of learning in undergraduate nursing education. In spite of this, how nursing students learn in clinical practice is still largely unknown. Moreover, there is no conceptual clarity on learning in practice in the current literature. This paper aims to set up a protocol for a scoping review of the literature in order to map different conceptualisations of learning in practice in undergraduate clinical nursing education in the hospital setting. The operationalisations of different concepts will be compared and the findings of the studies will be synthesised.Methods and analysisThis scoping review will be guided by the methodological framework proposed by Arksey and O'Malley and refined by Levac et al. and the Joanna Briggs Institute. The search strategy will be developed together with a medical information specialist and the search will be performed in electronic databases (PubMed, EBSCO/ERIC and EBSCO/CINAHL). In a first search, we will identify concepts that are used as an equivalent to learning in practice. Next, we will search for studies operationalising these concepts in undergraduate nursing education. Finally, we will check reference lists for additional publications. Abstracts and full-text studies will independently be screened by two researchers. All studies that have 'learning in undergraduate clinical nursing practice' as their main topic and that include a definition and operationalisation of an equivalent to learning in clinical practice, will be considered for inclusion. We will chart different conceptualisations and their theoretical underpinnings, as well as reported learning opportunities, informal and formal aspects of learning, social aspects of learning and gaps in the literature.Ethics and disseminationThis review will help design future studies on learning in clinical nursing practice using well-defined and agreed on terminology. The results will be disseminated through journal publications and conference presentations.

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Proposing a re-conceptualisation of competency framework terminology for health: a scoping review.

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Proposing a re-conceptualisation of competency framework terminology for health: a scoping review.

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