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

Abstract

Competency framework development in health professions has downstream implications for all relevant stakeholders, from the professionals themselves, to organisations, and most importantly end users of services. However, there is little guidance related to what stakeholders might be involved in the competency development process, and when. This review aimed to systematically review literature related to competency framework development methodology in health, to identify the breadth and purpose of key stakeholders commonly involved in the process. Studies were identified using five electronic databases (MEDLINE, PubMed, CINAHL, EMBASE, and ERIC) and a search of websites of organisations involved in curriculum or regulation using keywords related to competency frameworks. The total yield from all databases was 10,625 results, with 73 articles included in the final review. Most articles were from Australia (30%) and were conducted in the nursing (34%) profession. Unsurprisingly, practitioners (86%) and academics (75%) were typically engaged as stakeholders in competency framework development. While many competency frameworks were described as patient-focused, only 14 (19%) studies elected to include service users as stakeholders. Similarly, despite the multi-disciplinary focus described in some frameworks, only nine (12%) studies involved practitioners from other professions. 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 important stakeholder groups. Future methodology should attempt to engage a variety of relevant stakeholders such as external health professions and the community to match professional education to health service demands.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=128350

Does patient and public involvement influence the development of competency frameworks for the health professions? A systematic review

“…Competency frameworks typically describe professional expectations of healthcare professionals by defining the perceived knowledge, skills, attitudes and other characteristics required to practice safely and effectively (1). They translate professional practice to activities such as assessment, curriculum design and educational frameworks, professional regulation, and clinical specialization (1)(2)(3)(4). Despite this central role they play in developing and regulating professional practice (4), standardized approaches to developing competency frameworks are lacking (5).…”

“…Despite this central role they play in developing and regulating professional practice ( 4 ), standardized approaches to developing competency frameworks are lacking ( 5 ). Uncertainty exists regarding which stakeholders to involve and for what purposes during the development of competency frameworks for health professions ( 2 ). A recent scoping review found significant variation in methodological approaches to competency framework development; a single, internationally recognized standard was not identified ( 5 ).…”

“…Within health professions education, there is a growing evidence base regarding patient and public involvement in teaching practices ( 9 ); however, their input into curriculum and competency framework development is less defined. While “patient-centered care” was reported as central in the development of most health professions frameworks in recent reviews, patient and public involvement during their development was lacking ( 2 , 5 ). The specific methods used to engage patients and the public, the purpose of their engagement and the outcome of this engagement on the competency framework was beyond the scope of these reviews.…”

Struggling with the logic of EPA frameworks

“…In the article, Making Prospective Entrustment Decisions: Knowing Limits, Seeking Help, and Defaulting, Schumacher et al 3 4 To implement with fidelity, CCCs are meant to review high-quality data from a program of assessment, interrogate this data and follow best practices in group decision making to inform defensible decisions about trainee progress and individualised resident learning plans to facilitate trainee progression towards competence. 5 As such, in CBME, the program of assessment (actioned via CCC's) is intended to serve two purposes: assessment of learning and assessment for learning.…”

“…This is understandable when considering how these EPA frameworks are generated. Lepre et al 3 identified a sameness to the stakeholder consultation processes in generating EPA frameworks. Most consulted were practitioners and academics, with less than one in five involving those with other workplace perspectives such as service users, policy makers, practitioners from another profession and students.…”