Health informatics competencies in postgraduate medical education and training in the UK: a mixed methods study

Abstract

ObjectiveTo assess health informatics (HI) training in UK postgraduate medical education, across all specialties, against international standards in the context of UK digital health initiatives (eg, Health Data Research UK, National Health Service Digital Academy and Global Digital Exemplars).DesignA mixed methods study of UK postgraduate clinician training curricula (71 specialties) against international HI standards: scoping review, curricular content analysis and expert consultation.Setting and participantsA scoping literature review (PubMed until March 2017) informed development of a contemporary framework of HI competency domains for doctors. National training curricula for 71 postgraduate medical specialties were obtained from the UK General Medical Council and were analysed. Seven UK HI experts were consulted regarding findings.OutcomesThe International Medical Informatics Association (IMIA) Recommendations for Biomedical and Health Informatics Education were used to develop a framework of competency domains. The number (maximum 50) of HI competency domains included in each of the 71 UK postgraduate medical specialties was investigated. After expert review, a universal HI competency framework was proposed.ResultsA framework of 50 HI competency domains was developed using 21 curricula from a scoping review, curricular content analysis and expert consultation. All 71 UK postgraduate medical curricula documents were mapped across 29 of 50 framework domains; that is, 21 domains were unrepresented. Curricula mapped between 0 (child and adolescent psychiatry and core surgical training) and 16 (chemical pathology and paediatric and perinatal pathology) of the 50 domains (median=7). Expert consultation found that HI competencies should be universal and integrated with existing competencies for UK clinicians and were under-represented in current curricula. Additional universal HI competencies were identified, including information governance and security and secondary use of data.ConclusionsPostgraduate medical education in the UK neglects HI competencies set out by international standards. Key HI competencies need to be urgently integrated into training curricula to prepare doctors for work in increasingly digitised healthcare environments.

A Digitally Competent Health Workforce: Scoping Review of Educational Frameworks

“…In terms of geographical relevance, 15 frameworks were country-specific [ 21 , 33 , 37 , 38 , 40 , 42 , 45 , 47 , 48 , 50 , 55 - 59 ], 1 was specific to the European Union region [ 61 ], 5 were applicable globally [ 35 , 36 , 41 , 49 , 52 , 54 ], and the remaining did not specify (n=9). In terms of health care settings, 4 were developed for remote care delivery [ 39 , 51 , 53 , 60 ], 1 framework each for hospitals [ 48 ], acute care [ 41 ], and homecare [ 50 ], while the remaining frameworks either were applicable to all health care settings (n=5) [ 42 , 45 , 56 , 57 , 59 ] or did not specify (n=18).…”

“…Among the nursing frameworks, 7 were meant for in-service nurses [ 21 , 31 , 32 , 42 - 44 , 46 , 48 ], 5 for preservice nursing students [ 33 - 37 , 53 , 58 ], and 2 for both [ 22 , 50 ]. Of the 4 medicine-focused frameworks, one focused on in-service doctors [ 40 ], another on preservice medical students [ 55 ], and 2 on both [ 59 , 60 ]. The framework characteristics and summary of the findings of the included studies are presented in Table 1 and Table 2 , respectively.…”

“…Competencies were organized either based on broad informatics categories (ie, computer skills, informatics knowledge, informatics skills) [ 21 , 22 , 31 , 32 , 42 , 44 , 45 , 48 , 53 ] or a combination of informatics and noninformatics categories (ie, information systems concepts, management concepts, ethical or legal concepts) [ 38 , 41 , 46 , 59 - 61 ] or based on health care worker roles (ie, communicator, collaborator, professional) [ 33 - 36 , 51 , 52 , 54 , 55 ]. Alternatively, competencies were sorted according to learning outcomes or statements [ 37 , 39 , 40 , 43 , 47 , 49 , 50 , 56 - 58 ]. For example, the national guideline for Canadian registered nurses sorted competencies according to 3 overarching statements: (1) uses relevant information and knowledge to support the delivery of evidence-informed patient or client care; (2) uses IT in accordance with professional and regulatory standards and workplace policies; and (3) uses IT in the delivery of patient or client care [ 37 ].…”

Digital health leadership: carving a new pathway

“…Postgraduate training generally neglects the expected standards of health informatics training and, on its own, would have been insufficient. 14 If the government, policy makers and senior leaders are serious about supporting digital health leadership, then they will need to bring about changes to undergraduate training and also open career opportunities to the widest group of health workers. NHS hiring managers and recruiters will also need to take a broader view and that may mean recruiting people based on their digital health skills and not simply because a clinical informatics role may suit a job plan.…”

Improving the digital health of the workforce in the COVID-19 context: an opportunity to future-proof medical training

“…Previous work highlighted how a set of unified competencies in informatics across medical specialties is lacking. 2 Although, more recently, a universal health informatics competency framework has been launched by the Faculty of Clinical Informatics, there is clearly much more to do in order to increase the salience and impact of such work. 3 As a result of the COVID-19 pandemic, there is now an opportunity to capitalise on the impetus to ensure that digital health technology continues to play a central and growing role in the future clinical model of healthcare delivery.…”