From prescription to guidance: a European framework for generic competencies

Abstract

In postgraduate medical education, required competencies are described in detail in existing competency frameworks. This study proposes an alternative strategy for competencybased medical education design, which is supported by change management theories. We demonstrate the value of allowing room for re-invention and creative adaptation of innovations. This new strategy was explored for the development of a new generic competency framework for a harmonised European curriculum in Obstetrics and Gynaecology. The generic competency framework was developed through action research. Data were collected by four European stakeholder groups (patients, nurses, midwives and hospital boards), using a variety of methods. Subsequently, the data were analysed further in consensus discussions with European specialists and trainees in Obstetrics and Gynaecology. These discussions ensured that the framework provides guidance, is specialty-specific, and that implementation in all European countries could be feasible. The presented generic competency framework identifies four domains: 'Patient-centred care', 'Teamwork', 'System-based practice' and 'Personal and professional development'. For each of these four domains, guiding competencies were defined. The new generic competency framework is supported by European specialists and trainees in Obstetrics and Gynaecology, as well as by their European stakeholders. According to change management theories, it seems vital to allow room for re-invention and creative adaptation of the competency framework by medical professionals. Therefore, the generic competency framework offers guidance rather than prescription. The presented strategy for competency framework development offers leads for implementation of competency-based medical education as well as for development of innovations in postgraduate medical education in general.

Stakeholder Engagement in Competency Framework Development in Health Professions: A Systematic Review

“…This is unsurprising, however there is no indication that this is best practise, but rather a reflection on the current status of competency-based education ( 22 ). Patients today expect healthcare professionals to not only be experts in their field, but also to work successfully in a team, provide patient-centred care and communicate effectively with patients and colleagues ( 85 , 86 ). Limiting the conceptualisation of competence to that determined by members of the profession itself may not provide the depth of insight required to capture the complexity of healthcare and address the needs of key stakeholder groups, such as service users ( 9 ).…”

A Six-Step Model for Developing Competency Frameworks in the Healthcare Professions

“…This detailed the shortcomings of the existing guidance, and highlighted several items that needed to be considered in the model. Second, we identified, organized, and synthesized the existing guidance on developing competency frameworks from multiple sources ( 9 – 11 , 15 – 27 ). These sources were informed by our scoping review ( 1 ), and contemporary methodological approaches ( 22 – 27 ).…”

“…Second, we identified, organized, and synthesized the existing guidance on developing competency frameworks from multiple sources ( 9 – 11 , 15 – 27 ). These sources were informed by our scoping review ( 1 ), and contemporary methodological approaches ( 22 – 27 ). We approached this organization and synthesis as a form of qualitative data analysis ( 28 )—we iteratively analyzed the data, extracted the individual elements of guidance from each source, and then created categories of data from the elements (e.g., coding, and collapsing of codes).…”

A Six-Step Model for Developing Competency Frameworks in the Healthcare Professions

“…This detailed the shortcomings of the existing guidance, and highlighted several items that needed to be considered in the model. Second, we identified, organized, and synthesized the existing guidance on developing competency frameworks from multiple sources (9)(10)(11)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). These sources were informed by our scoping review (1), and contemporary methodological approaches (22)(23)(24)(25)(26)(27).…”

“…Second, we identified, organized, and synthesized the existing guidance on developing competency frameworks from multiple sources (9)(10)(11)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). These sources were informed by our scoping review (1), and contemporary methodological approaches (22)(23)(24)(25)(26)(27). We approached this organisation and synthesis as a form of qualitative data analysis (28)we iteratively analysed the data, extracted the individual elements of guidance from each source, and then created categories of data from the elements (e.g.…”