Strategies for Developing Competency Models

Building a Competency Framework to Integrate Inter-disciplinary Precision Medicine Capabilities into the Medical Technology and Pharmaceutical Industry

INTRODUCTION

Integration of precision medicine (PM) competencies across the Medical Technology and Pharmaceutical industry is critical to enable industry professionals to understand and develop the skills needed to navigate the opportunities arising from rapid scientific and technological innovation in PM. Our objective was to identify the key competency domains required by industry professionals to enable them to upskill themselves in PM-related aspects of their roles.

METHODS

A desktop research review of current literature, curriculum, and healthcare trends identified a core set of domains and subdomains related to PM competencies that were consistent across multiple disciplines and competency frameworks. A survey was used to confirm the applicability of these domains to the cross-functional and multi-disciplinary work practices of industry professionals. Companies were requested to trial the domains to determine their relevance in practice and feedback was obtained.

RESULTS

Four PM-relevant domains were identified from the literature review: medical science and technology; translational and clinical application; governance and regulation and professional practice. Survey results refined these domains, and case studies within companies confirmed the potential for this framework to be used as an adjunct to current role specific competency frameworks to provide a specific focus on needed PM capabilities.

CONCLUSION

The framework was well accepted by local industry as a supplement to role specific competency frameworks to provide a structure on how to integrate new and evolving technologies into their current workforce development planning and build a continuous learning and cross-disciplinary mindset.

Perspectives on systematic capacity building in pharmaceutical regulation for regulators of medical products

Having a robust, integrated regulatory system is important for ensuring the availability of safe and efficacious medical products of good quality and for protecting public health. However, less than 30% of countries globally have reached the required regulatory maturity level three, with low- and middle-income countries facing challenges in attracting and retaining qualified staff. World Health Organization (WHO) advocates for systematic workforce development, including competency-based education, to address these gaps. We provide perspectives on a systematic approach to capacity building of medicine regulators based on the experience and lessons learnt in developing and piloting the WHO global competency framework for medicine regulators through three scenarios. A systematic approach to capacity building, such as the human performance technology model, can be used to implement the WHO competency framework as part of organizational performance improvement while ensuring that initiatives are well-defined, targeted, and aligned with organizational goals. The competency framework can be used in different contexts, such as improving organization performance for individual regulatory authorities, strengthening regional collaborations, harmonization and reliance on medical products assessment and joint good manufacturing practices inspections of pharmaceutical manufacturers, and developing learning programs for medicine regulators. A competency-based learning approach for regulatory professionals ensures the transfer of learning to the workplace by integrating real-world practices in learning activities and assessments. Further work is required to develop and validate the assessment instruments, apply the competency framework in other contexts, expanding the learning programmes while continuously providing feedback for further refinement of the competency framework and implementation support tools.

Guidance for management competency identification and development in the health context: a systematic scoping review

BACKGROUND

Using management competency-based frameworks to guide developing and delivering training and formal education to managers has been increasingly recognized as a key strategy in building management capacity. Hence, interest in identifying and confirming the competency requirements in various contexts have been witnessed. Therefore, learnings from how competency studies were designed and conducted, how competencies were identified, and strategies in ensuring success in competency identification are of great value to researchers planning and conducting competency studies in their own country.

METHODS

A scoping review was conducted guided by the Arksey and O'Malley framework and reported according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR). All papers that published empirical studies aiming at identifying and assessing manager's competencies at the peer-reviewed journals were identified from Web of sciences, PubMed, Scopus and Emerald Management between 2000 and 2021. In order to maximize learning, studies focusing on health and non-health sectors are all included.

RESULTS

In total, 186 studies were included in the review including slightly more than half of the studies conducted in health sector (54.5%). 60% of the studies focused on mid to senior level managers. Surveys and Interviews were the two most commonly used methods either solely or as part of the mix-method in the studies. Half of the studies used mixed methods approach (51.1%). Large proportion of the papers failed to include all information that is necessary to contribute to learning and improvement in future study design. Based on the results of the scoping review a four steps framework was developed that can guide designing and implementing management competency studies in specific country vs. sector context and to ensure benefits of the studies are maximised.

CONCLUSION

The review confirmed the increasing trend in investing in management competency studies and that the management competency identification and development process varied substantially, in the choice of methods and processes. The identification of missing information in majority of the published studies calls for the development of more rigorous guidelines for the peer-review process of journal publications. The proposed framework of improving the quality and impact of the future management competency study provides clear guidance to management competency identification and development that promotes the functional alignment of methods and strategies with intended uses and contexts.

Competencies required by patients and health professionals regarding telerehabilitation: A scoping review

Background

Telerehabilitation offers patients alternative access to therapy and has become more prominent during the COVID-19 pandemic. Despite the increasing attractiveness of such programs, there are research gaps regarding the required competencies in the demand-oriented technology use in rehabilitative care.

Objective

The study aims at collecting evidence on competencies required by patients and health professionals for using telerehabilitation. We analyse tasks and requirements associated with telerehabilitation and derive and systematise relevant competencies.

Methods

We conducted a scoping review and analysed MEDLINE, Psyndex, EMBASE, Cochrane Library, and Web of Science for empirical studies and grey literature from 2017 to May 2022. Articles had to be in English/German and refer to medical rehabilitation accompanied by health professionals taking place in the patient's home.

Results

One hundred ten articles were included, covering video conferencing systems, applications with video, audio, or visual therapy content, or wearables. Depending on the program, tasks before, during, and after therapy sessions differ, as do whether these are performed by health professionals, patients, or the technology. Users need digital, health-related, social, personal, and health professionals also professional competencies. This comprises telerehabilitation, technical, health-related, and clinical knowledge, a range of physical, cognitive, social-interactive, technical, and clinical skills, a positive attitude towards telerehabilitation and experience. Whether sociodemographic factors promote successful use is unclear.

Conclusions

Telerehabilitation requires a variety of different competencies from patients and health professionals - going beyond the sphere of technical skills. This highlights the need for an evaluation of existing programs for promoting competencies in the use of telerehabilitation and refinement of the programs in line with demands.

CTiBS and Clinical Social Work: Telebehavioral Health Competencies for LCSWs in the Age of COVID-19

Licensed Clinical Social Workers (LCSWs) have been integrating technology into psychotherapy practice for at least two decades, but the COVID-19 pandemic dramatically shifted the primary method of service delivery for diagnostic assessment and therapy to telebehavioral health. By developing telebehavioral health competencies, the 250,000 + LCSWs in the US can ensure and enhance the quality of care both during and after the COVID public health emergency (PHE). This article applies an evidence- and consensus-based, interprofessional telebehavioral health (TBH) competency framework to the field of social work. This framework was developed by the Coalition for Technology in Behavioral Science (CTiBS), initially published in 2017. It has seven competency domains: (1) clinical evaluation and care; (2) virtual environment and telepresence; (3) technology; (4) legal and regulatory issues; (5) evidence-based and ethical practice (comprised of Standards and Guidelines and Social Media); (6) mobile health and apps; and (7) telepractice development. The framework outlines three competency levels (novice, proficient, and authority) covering 49 specific objectives and 146 measurable competencies or practices. The TBH competencies support existing in-person clinical practices and are intended for trainees and practitioners who are implementing TBH in practice. This competency framework can also be used to integrate clinical social work professional development, research, and training. Additionally, considerations for other behavioral health professions regarding licensure, certification, and policy may apply to clinical social work. Future research is needed on implementation and evaluation of the competencies.

Evaluation of Teachers' Innovation and Entrepreneurship Ability in Universities Based on Artificial Neural Networks

Based on iceberg theory and the questionnaire of competency’s elements, hierarchical index system of evaluation of teachers' innovation and entrepreneurship competency in universities is established. Through researches, we think that analytic hierarchy process(AHP) is a more scientific and reasonable evaluation method whose rationality is checked by satisfactory consistency while the evaluation model of artificial neutral network doesn’t consider weighting. If the samples are more than 30, the evaluation of neural network model of teachers' innovation and entrepreneurship competency can achieve the accurate results and satisfactory requirements. Since the method of artificial neutral network has advantages of strong operability, simple rules and minor errors, it can greatly reduce the workload because it not only eliminates human subjectivity of evaluation and greatly simplifies the process of evaluation, but also improves working efficiency and provides a new way of thinking for evaluation of the teachers' innovation and entrepreneurship competency in universities

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

Competency frameworks are developed for a variety of purposes, including describing professional practice and informing education and assessment frameworks. Despite the volume of competency frameworks developed in the healthcare professions, guidance remains unclear and is inconsistently adhered to (perhaps in part due to a lack of organizing frameworks), there is variability in methodological choices, inconsistently reported outputs, and a lack of evaluation of frameworks. As such, we proposed the need for improved guidance. In this paper, we outline a six-step model for developing competency frameworks that is designed to address some of these shortcomings. The six-steps comprise [1] identifying purpose, intended uses, scope, and stakeholders; [2] theoretically informed ways of identifying the contexts of complex, "real-world" professional practice, which includes [3] aligned methods and means by which practice can be explored; [4] the identification and specification of competencies required for professional practice, [5] how to report the process and outputs of identifying such competencies, and [6] built-in strategies to continuously evaluate, update and maintain competency framework development processes and outputs. The model synthesizes and organizes existing guidance and literature, and furthers this existing guidance by highlighting the need for a theoretically-informed approach to describing and exploring practice that is appropriate, as well as offering guidance for developers on reporting the development process and outputs, and planning for the ongoing maintenance of frameworks.

New ways of seeing: supplementing existing competency framework development guidelines with systems thinking

Competency frameworks provide a link between professional practice, education, training, and assessment. They support and inform downstream processes such as curriculum design, assessment, accreditation and professional accountability. However, existing guidelines are limited in accounting for the complexities of professional practice potentially undermining utility of such guidelines and validity of outcomes. This necessitates additional ways of "seeing" situated and context-specific practice. We highlight what a conceptual framework informed by systems thinking can offer when developing competency frameworks. Mirroring shifts towards systems thinking in program evaluation and quality improvement, we suggest that similar approaches that identify and make use of the role and influence of system features and contexts can provide ways of augmenting existing guidelines when developing competency frameworks. We framed a systems thinking approach in two ways. First using an adaptation of Ecological Systems Theory which offers a realist perspective of the person and environment, and the evolving interaction between the two. Second, by employing complexity thinking, which obligates attention to the relationships and influences of features within the system, we can explore the multiple complex, unique, and context-embedded problems that exist within and have stake in real-world practice settings. The ability to represent clinical practice when developing competency frameworks can be improved when features that may be relevant, including their potential interactions, are identified and understood. A conceptual framework informed by systems thinking makes visible features of a practice in context that may otherwise be overlooked when developing competency frameworks using existing guidelines.

Constructing and Validating Competence Indicators for Professional Technicians in Fire Safety in Taiwan

This study constructed professional competence indicators for technical personnel in fire safety equipment that can be used to guide curriculum planning of fire-protection-related programs in colleges and universities; training of technical personnel in fire safety equipment in the industry; and the mandatory national examinations for technical personnel in fire protection. To achieve the purpose of this study, document analysis, expert interviews, and the Delphi technique were used to verify that there are three first-level dimension indicators. These three primary indicators were categorized as knowledge, skills, and attitude, with an additional 12 second-level orientation indicators and 61 third-level detailed indicators. Furthermore, in relation to the importance–performance analysis, the falling point distribution of the detailed indicators of technical personnel in fire protection in the four quadrants of the IPA model chart was obtained in order to provide a reference for the industry, government, and academia.

Toward proficiency in telebehavioral health: applying interprofessional competencies in couple and family therapy

During the coronavirus pandemic, many behavioral health professionals providing psychotherapeutic services, including couple/marriage and family therapists (C/MFTs), quickly changed from providing in-person services to telebehavioral health (TBH) services, with specific reliance on teleconferencing. Many therapists were thrust into telehealth with minimal or no prior telebehavioral health experience, education, or training. Although TBH services have been shown to be effective and efficient with mental health and substance abuse problems, the teaching and learning of telebehavioral competencies have generally not been included in the formal education and training received by C/MFTs. This article presents an existing interprofessional telebehavioral health competencies framework not before published in C/MFT journals. This article will also demonstrate how those competencies are applicable to the education, training, and practice of telebehavioral health by C/MFTs. Implications for educational, service, and regulatory organizations are presented.

Developing competent public hospital managers: a qualitative study from Iran

Purpose

Hospitals need highly trained and competent managers to be responsible for the strategic development, overall operation and service provision. The identification and confirmation of core management competency requirements is a fundamental first step towards developing the competent management workforce for sustainable hospital service provision. This paper reports on the finding of a recent study focusing on identifying managerial competencies required by middle and senior-level managers in the public hospitals in Iran.

Design/methodology/approach

The qualitative research design included position description analysis and focus group discussions with middle and senior-level public hospital managers in Iran. When analysing the identified knowledge, skills and attitudes, the validated MCAP framework was used to guide the grouping of them into associating management competencies.

Findings

The study identified 11 to 13 key tasks required by middle and senior-level managers and confirmed that the position descriptions used by current Iranian hospitals might not truly reflect the actual core responsibilities of the management positions. The study also confirmed seven core managerial competencies required to perform these tasks effectively. These core competencies included evidence-informed decision-making; operations, administration and resource management; knowledge of healthcare environment and the organisation; interpersonal, communication qualities and relationship management; leading people and organisation; enabling and managing change and professionalism.

Research limitations/implications

Competencies were identified based on managers' perceptions. Views and experiences of other stakeholders were not captured.

Practical implications

The seven core management competency identified in the current study provides a clear direction of competency development among senior and middle-level managers working at the Iranian public hospitals. The study also confirms that position descriptions do not reflect the actual responsibilities of current hospital managers, which are in need to urgent review.

Originality/value

This is the first study that has identified the core managerial competencies required by middle and senior-level hospital managers in Iran.

Relationship between Personal Values, Work Experience and Nursing Competencies among Cancer Care Nurses in Malaysia

Oncology nurses are an essential component of cancer care teams. Nurses play a vital role in ensuring that cancer patients comply with their cancer treatment. In the cancer care nursing context, competency is not merely being skilled, but also implies the characteristic of being able to perform effectively. In addition to the need for competence, nursing is a discipline rich in values including human dignity, caring, humanity, and respect for personal privacy. Research from a variety of disciplines indicates that values often influence human behaviour in professional and work settings. It is often believed, therefore, that nurse' values and work experience influence and contribute to their work performance. Few studies have attempted to examine these relationships, particularly in the context of cancer care nursing. The purpose of this study was to determine the relationship between personal values, work experience and competency among cancer care nurses in Malaysia. Quantitative surveys were used to collect the data. A total of 845 cancer care nurses from 38 public hospitals in Peninsular Malaysia participated in the study. Descriptive statistics and Pearson Product-Moment Correlations were used to analyse the data. The findings revealed positive and significant relationships between personal values and competency (r = 0.59, p < 0.01) and work experience and competency (r = 0.11, p < 0.047). The findings support the assertion that Malaysian nurses' values and work experience are related to performance-related competency.
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Sustainable Smart Cities and Energy Management: The Labor Market Perspective

Nowadays, sustainability is one of the strategic goals of smart cities. They are the essential solution to creating the sustainable future. On the other hand, the smart city is intended to deal with the problems of energy management. This paper examines the influence of the smart sustainable cities concept on energy management from the labor market perspective. The paper fulfills the research gap about energy manager profession transformation considering smart sustainable city concept. The aim of the paper is to create an up-to-date holistic energy manager skill model with a focus on emerging technologies. The skill model reflects the synergy of two methodological approaches: the theoretical and practical approaches. Descriptive statistics are used to present the labor market research results. It is concluded that the core elements of the smart sustainable city concept have an impact on energy management are sustainability and big data. The labor market research also draws differences in the amount and structure of demand on energy manager skills by countries, but at the same time similar skills requirements are found. The skill model of the energy manager profession is built around several main groups associated with specific knowledge, social skills, and behavior skills. The findings of the present research can contribute to knowledge and practice by applying it in the process of developing energy manager competency models in commercial and non-commercial enterprises as well as in education programs and training courses.

The development of competency frameworks in healthcare professions: a scoping review

Competency frameworks serve various roles including outlining characteristics of a competent workforce, facilitating mobility, and analysing or assessing 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. We applied the Arksey and O'Malley framework to undertake this scoping review. We searched six electronic databases (MEDLINE, CINAHL, PsycINFO, EMBASE, Scopus, and ERIC) and three grey literature sources (greylit.org, Trove and Google Scholar) using keywords related to competency frameworks. We screened studies for inclusion by title and abstract, and we included studies of any type that described the development of a competency framework in a healthcare profession. Two reviewers independently extracted data including study characteristics. Data synthesis was both quantitative and qualitative. Among 5710 citations, we selected 190 for analysis. The majority of studies were conducted in medicine and nursing professions. Literature reviews and group techniques were conducted in 116 studies each (61%), and 85 (45%) outlined some form of stakeholder deliberation. We observed a significant degree of diversity in methodological strategies, inconsistent adherence to existing guidance on the selection of methods, who was involved, and based on the variation we observed in timeframes, combination, function, application and reporting of methods and strategies, there is no apparent gold standard or standardised approach to competency framework development. We observed significant variation within the conduct and reporting of the competency framework development process. While some variation can be expected given the differences across and within professions, our results suggest there is some difficulty in determining whether methods were fit-for-purpose, and therefore in making determinations regarding the appropriateness of the development process. This uncertainty may unwillingly create and legitimise uncertain or artificial outcomes. There is a need for improved guidance in the process for developing and reporting competency frameworks.

Toward Cognitive Management Accounting

This paper examines the impact of cognitive technologies in management accounting. The purpose of the research was to create the current management accountant skills model. The main contributions of this paper are the literature study of the future of management accounting, the study of the impact of cognitive technologies on management accounting, the labor market research, and the current management accountant skills model. The purpose of the literature study was to highlight the opportunities and challenges of the application of cognitive technologies to management accounting and the role of cognitive abilities in the management accountant profession. The labor market study was conducted in order to analyze the impact of cognitive technologies on the management accountant profession and identify the core skills required. The paper fulfills the research gap regarding the impact of cognitive information technologies on management accounting and the management accountant profession in terms of smart and sustainable organization conception. The number of job positions with cognitive analytic skills, big data skills, cognitive abilities, and additional skills and competencies was identified. Although the research reveals differences in the demand for skills and abilities among the studied countries, the common skills model for managerial accountants was successfully created.

Selected psychological comorbidities in coronary heart disease: Challenges and grand opportunities

Evidence of popular interest in the interrelationships between mind, body, and heart disease dates to Ancient Grecian times and paved the way for modern-day scientific inquiry into the relationships between psychological comorbidities in coronary heart disease. Although the systematic evidence has suggested an association of poor medical prognosis and lower quality of life among patients with coronary heart disease with comorbid psychological conditions, the mechanisms are less well understood. In this selective review article, the epidemiology, mechanisms, screening, and treatment recommendations for 4 common psychological conditions (depression, anxiety, stress, and insomnia) comorbid with coronary heart disease are presented. We focus on the grand challenges and unprecedented opportunities for research in this area considering the methodological and technological innovations of the 21st century. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

A Framework of Interprofessional Telebehavioral Health Competencies: Implementation and Challenges Moving Forward

Interprofessional telebehavioral health (TBH) competencies have been developed to standardize training and improve the quality of TBH care. The seven identified interprofessional TBH competency domains and three levels of expertise (novice, proficient, and authority) are briefly described. More in depth descriptions and examples of several of the competency domains are presented to illustrate what the competencies look like in practice. Some of the challenges faced in using such a competency framework are discussed.

Identifying military family cultural competencies: experiences of military and Veteran families in Canadian health care

Introduction: Military family life is characterized by mobility, separation, and increased risk for injury or death of the military member, which impacts the health and well-being of all family members. Additional stress is experienced when accessing and navigating a new health care system. Unknown to most Canadians is the reality that military and Veteran families (MVFs) access the civilian health care system; this indicates a need for military family cultural competency among health care providers. This current research identifies aspects of military family cultural competency to inform health care provision to MVFs. Method: A qualitative study using one-on-one interviews was completed with MVFs. Critical Incident Technique (CIT) was used to develop interview questions. Framework analysis was used for data analysis. Results: In total 17 interviews were completed including:1 family (female military spouse, male military member and child); 1 male Veteran; and 15 female military spouses (1 Veteran; 1 active member). Military family cultural competency domains such as cultural knowledge (characteristics of military families; impacts of mobility, separation, and risk) and cultural skills (building relationships; use of effective and appropriate assessments and interventions) were identified. The ecological context was also described as impacting the health care experience. Discussion: The reported experiences of MVFs in this study have highlighted the gaps in the military family cultural knowledge and military family cultural skills Canadian health care providers have when providing care. Results of this study can be used to develop continuing education for health professionals and inform future research.

Les accompagnants à l’insertion professionnelle en milieu ordinaire pour les personnes en situation de handicap psychique au sein des ESAT de transition Messidor

Les dispositifs d’aide à la réinsertion professionnelle des personnes souffrant de troubles psychiques sont peu étudiés en France bien que la littérature spécialisée souligne que ces dispositifs sont clés pour favoriser l’insertion en milieu ordinaire. Les objectifs de cette recherche étaient de décrire les rôles, tâches et compétences des conseillers d’insertion et des responsables d’unité de production qui accompagnent ce public vers le milieu ordinaire au sein des ESAT de transition Messidor. Une méthodologie qualitative a été retenue : 24 entretiens individuels et 7 groupes de discussion ont été menés auprès des deux types de professionnels de ces structures. Les résultats ont permis de définir la fonction de chaque accompagnant et une liste de 110 compétences pour les conseillers d’insertion et de 155 compétences pour les responsables de production. Ce binôme d’accompagnants complémentaires apporte un soutien à l’insertion en favorisant un changement de regard sur soi. Le conseiller d’insertion accompagne chaque travailleur à construire et réaliser un projet d’insertion, tout en assurant la liaison entre différents partenaires externes de la collectivité (ex. employeurs, équipe soignante). En parallèle, au quotidien, le responsable de production assure une formation dans un métier, propose des défis à relever, ce qui contribue à restaurer l’estime de soi professionnelle des personnes, facteur clé pour l’insertion en milieu ordinaire. Les implications cliniques de cette recherche concernent le recrutement, la formation et la supervision des personnels accompagnant vers l’emploi.

Enhancing the Evidence for Behavioral Counseling: A Perspective From the Society of Behavioral Medicine

U.S. Preventive Services Task Force (USPSTF) clinical guidelines at present rarely assign the highest grade recommendation to behavioral counseling interventions for chronic disease prevention or risk reduction because of concerns about the certainty and quality of the evidence base. As a result, the broad integration of behavioral counseling interventions in primary care remains elusive. Thus, there is an urgent need for novel perspectives on how to generate the highest-quality and -certainty evidence for primary care-focused behavioral counseling interventions. As members of the Society of Behavioral Medicine (SBM)--a multidisciplinary scientific organization committed to improving population health through behavior change--we review the USPSTF mandate and current recommendations for behavioral counseling interventions and provide a perspective for the future that calls for concerted and coordinated efforts among SBM, USPSTF, and other organizations invested in the rapid and wider uptake of beneficial, feasible, and referable primary care-focused behavioral counseling interventions. This perspective highlights five areas for further development, including (1) behavioral counseling-focused practice-based research networks; (2) promotion of USPSTF evidence standards and the increased use of pragmatic RCT design; (3) quality control and improvement procedures for behavioral counseling training; (4) systematic research on effective primary care-based collaborative care models; and (5) methodologic innovations that capitalize on disruptive technologies and healthcare transformation. Collective efforts to improve the health of all Americans in the 21st century and beyond must ensure that effective, feasible, and referable behavioral counseling interventions are embedded in modern primary care practice.

Towards an Operational Definition of Clinical Competency in Pharmacy

OBJECTIVE

To estimate the inter-rater reliability and accuracy of ratings of competence in student pharmacist/patient clinical interactions as depicted in videotaped simulations and to compare expert panelist and typical preceptor ratings of those interactions.

METHODS

This study used a multifactorial experimental design to estimate inter-rater reliability and accuracy of preceptors' assessment of student performance in clinical simulations. The study protocol used nine 5-10 minute video vignettes portraying different levels of competency in student performance in simulated clinical interactions. Intra-Class Correlation (ICC) was used to calculate inter-rater reliability and Fisher exact test was used to compare differences in distribution of scores between expert and nonexpert assessments.

RESULTS

Preceptors (n=42) across 5 states assessed the simulated performances. Intra-Class Correlation estimates were higher for 3 nonrandomized video simulations compared to the 6 randomized simulations. Preceptors more readily identified high and low student performances compared to satisfactory performances. In nearly two-thirds of the rating opportunities, a higher proportion of expert panelists than preceptors rated the student performance correctly (18 of 27 scenarios).

CONCLUSION

Valid and reliable assessments are critically important because they affect student grades and formative student feedback. Study results indicate the need for pharmacy preceptor training in performance assessment. The process demonstrated in this study can be used to establish minimum preceptor benchmarks for future national training programs.

Supervisor competencies for supporting return to work: a mixed-methods study

PURPOSE

Line supervisors often play an important role in the return to work (RTW) process; whether they possess the competencies needed to carry out this work effectively is unknown. The aim of this research was to determine the competencies supervisors need in order to facilitate a worker's RTW following absence due to a mental health condition or a musculoskeletal disorder.

METHODS

Supervisors from five Australian industries with high rates of compensable claims participated in focus groups to elicit the knowledge, skills, and personal characteristics required to support returning workers. From a multi-stage analysis of responses, RTW competencies were developed, allocated to clusters of related items, and incorporated into an online survey administered to rehabilitation professionals.

RESULTS

29 supervisors participated in 1 of 5 focus groups. Analysis of focus group data identified 84 generic competencies, eight specific to mental health conditions, and two to musculoskeletal disorders, arranged in 11 clusters. Survey respondents (n = 344) represented a variety of rehabilitation professionals and jurisdictions. Nearly all agreed that supervisors should receive training to support RTW. Over 50 % of respondents rated 90 of 94 competencies as very important or essential. The highest ratings were for competencies relating to personal attributes, knowledge of RTW processes, and empathetic support of the worker.

CONCLUSIONS

Supervisors and rehabilitation professionals perceive effective support of RTW requires supervisors to have a range of knowledge, skills, and personal characteristics. Our competency model should undergo workplace testing to evaluate its validity.

Federal Public Health Workforce Development: An Evidence-Based Approach for Defining Competencies

OBJECTIVE

This study reports the use of exploratory factor analysis to describe essential skills and knowledge for an important segment of the domestic public health workforce-Centers for Disease Control and Prevention (CDC) project officers-using an evidence-based approach to competency development and validation.

DESIGN

A multicomponent survey was conducted. Exploratory factor analysis was used to examine the underlying domains and relationships between competency domains and key behaviors. The Cronbach α coefficient determined the reliability of the overall scale and identified factors.

SETTING AND PARTICIPANTS

All domestic (US state, tribe, local, and territorial) grantees who received funding from the CDC during fiscal year 2011 to implement nonresearch prevention or intervention programs were invited to participate in a Web-based questionnaire.

MAIN OUTCOME MEASURE(S)

A total of 34 key behaviors representing knowledge, skills, and abilities, grouped in 7 domains-communication, grant administration and management, public health applied science and knowledge, program planning and development, program management, program monitoring and improvement, and organizational consultation-were examined.

RESULTS

There were 795 responses (58% response rate). A total of 6 factors were identified with loadings of 0.40 or more for all 34 behavioral items. The Cronbach α coefficient was 0.95 overall and ranged between 0.73 and 0.91 for the factors.

CONCLUSIONS

This study provides empirical evidence for the construct validity of 6 competencies and 34 key behaviors important for CDC project officers and serves as an important first step to evidence-driven workforce development efforts in public health.

Investigating the anatomy of the helping relationship in the context of psychiatric rehabilitation: the relation between working alliance, providers' recovery competencies and personal recovery

Professional helping relationships established with mental health consumers are vital in mental health recovery processes. However, little is known about how the constructs of alliance building and providers' recovery promoting strategies relate to each other and play a role in supporting recovery. To this end, we examined associations between consumer-reported working alliance, perceived providers' recovery competencies, and personal recovery. In a cross-sectional study design, 72 mental health consumers who established relationships with providers through a psycho-educational intervention over a period of 10 months in hourly weekly sessions were examined as part of a larger study conducted in mental health community settings in Israel. Participants filled in the Working Alliance Inventory (Tracey and Kokotovic, 1989), the Recovery Promoting Relationships Scale (Russinova et al., 2013), and Recovery Assessment Scale (Corrigan et al., 2004). Pearson correlations and linear regression analysis showed positive correlations between relational variables and recovery. A mediating model was identified whereby providers' recovery strategies positively impact the working alliance, which, in turn, positively impact consumers' recovery. Implications of the current study for future research and clinical practice are discussed, emphasizing the importance of examining recovery strategies and the working alliance with regard to the process of mental health recovery.

Organisational and leadership competencies for successful service integration

Purpose

– The purpose of this paper is to describe a two-part study that has explored the organisational and leadership competencies required for successful service integration within a health consortia in Australia. Preliminary organisational and leadership competency frameworks were developed to serve as reference points as the consortia it expanded to cater for increased service demand in the midst of significant health reform.

Design/methodology/approach

– The study design is outlined, which involved literature reviews and semi-structured interviews with key stakeholders to ascertain the key determinants of successful service integration at both organisational and leadership levels.

Findings

– The literature reviews revealed little existing research specifically focused on the organisational and leadership competencies that underpin successful service integration. The themes from the literature reviews and semi-structured interviews informed the preliminary organisational and leadership competency frameworks. Both frameworks are outlined in the paper. Key determinants of successful service integration – at both an organisational and individual leadership level – are also presented.

Research limitations/implications

– This is a one-organisation case study and the competency frameworks presented are preliminary. However, the study findings provide a foundation for further research focusing on the longer-term success of service integration.

Originality/value

– Service integration in health is a new and emerging area, and there is little extant research exploring the organisational and leadership competencies underpinning its success. The competency frameworks presented in the paper may be of interest to other consortia and organisations engaged in service integration and other forms of merger and collaboration.

Employment specialist competencies as predictors of employment outcomes

Employment specialist competencies were examined as predictors of employment outcomes for consumers with serious mental illness participating in supported employment. Self-report and supervisor-rated performance measures from 57 employment specialists were correlated with three consumer employment outcomes (i.e., competitive employment rate, 90-day employment rate, and dropout rate). Employment specialists varied from 0 to 80 % in the competitive employment rates for their caseloads. Supervisor ratings of job performance and employment specialist efficacy, percentage of time in the community, and frequency of contacts with consumers were associated with employment outcomes. Employment specialist self-report measures were unrelated to employment outcomes. Surprisingly, employment specialists with larger caseload sizes had higher employment rates. Employment specialists vary widely in their effectiveness. Behavioral measures and supervisory ratings of employment specialists were most predictive of employment outcomes. Direct observation of employment specialist job performance appears to be the most promising method for identifying competencies predictive of employment outcome.

The development of recovery competencies for in-patient mental health providers working with people with serious mental illness

Delivering recovery-oriented services is particularly challenging in in-patient settings. The purpose of this study was to identify the most salient recovery competencies required of in-patient providers. Established methods for the development of competencies were used. Data collection included interviews with multiple stakeholders and a literature review. Data analysis focused on understanding how characteristics of the in-patient context influence recovery-enabling service delivery and the competencies associated with addressing these issues. Eight core competencies with four to ten sub-competencies were identified based on a tension-practice-consequence model. The competency framework can serve as a tool for tailoring workforce education.

Broadening the Occupational Therapy Toolkit: An Executive Functioning Lens for Occupational Therapy With Children and Youth

OBJECTIVE. Attention to executive functioning (EF) and its effect on occupational performance is increasing in the occupational therapy literature. This study explored occupational therapists’ perceptions of how EF is recognized and addressed within occupational therapy for children and youth.

METHOD. Inductive qualitative content analysis was used to analyze the in-depth interview data from 13 occupational therapists with a range of practice contexts and experience.

RESULTS. EF should be explicitly considered during clinical reasoning. System and professional barriers create challenges to occupational therapists, constraining their ability to recognize, label, and address EF performance issues. Occupational therapists who have integrated EF into their practice perspective have acquired knowledge and skills through interprofessional collaborations, client interactions, and professional development opportunities.

CONCLUSION. Occupational therapists working with children and youth need an occupational EF framework and practice resources if they are to integrate an EF lens to more broadly enable occupational performance.

Competencies of more and less successful employment specialists

The competencies of individual employment specialists influence rates of competitive employment among consumers and programs. Identifying competencies can lead to the development of more effective specialists and improve employment outcomes for consumers enrolled in employment services in community mental health care settings. The purpose of this study was to examine how more successful employment specialists performed supported employment duties in comparison to less successful employment specialists. Ethnographic researchers observed more and less successful employment specialists performing job duties related to the five phases of supported employment. Using grounded theory, they identified factors that differentiated the two groups. More successful employment specialists worked efficiently, developed egalitarian relationships with consumers, and collaborated well with other partners. Less successful employment specialists understood the model but lacked these behavioral skills. Service providers should screen and train employment specialists for efficiency, flexibility, and interpersonal skills.

Clinical competencies for burn rehabilitation therapists

Nationally agreed-upon standards for competence are needed for burn physical and occupational rehabilitation therapists (BRTs) to define what constitutes safe and competent burn rehabilitation practice. Currently, consensus regarding the knowledge and skill components needed for the training and evaluation of BRT job performance is lacking. The Rehabilitation Committee of the American Burn Association used a staged, multimethod approach and input from more than 25 experts in the burn rehabilitation community to develop competency standards for BRTs. The result was the "Burn Rehabilitation Therapist Competency Tool" (BRTCT) that defines competency domains required of BRTs to provide physical and occupational therapy to patients with burn injury during their initial acute hospitalization and rehabilitation. This article describes the staged development and validation of the BRTCT. The component parts of the tool itself are presented, and the recommendations for assessment of competence are discussed. The BRTCT provides a common framework and language for expectations of performance in burn rehabilitation. Development of the BRTCT is a critical step in the ongoing process of promoting professional development and consistent practice standards in burn rehabilitation.

Beyond Microskills

Heeding the call to the profession, the authors present both a definition and model of counseling competence. Undergirding the model are 15 foundational principles. The authors conceptualize counseling competence as more complex and nuanced than do traditional microskills models and include cognitive, affective, and behavioral components. The model consists of 4 superordinate competencies—determining therapeutic outcomes, facilitating therapeutic outcomes, evaluating therapeutic outcomes, and sustaining therapeutic outcomes—and 12 subordinate competencies: self-appraisal/self-evaluating, structuring the therapy, building a therapeutic alliance, applying a conceptual map of therapeutic change, using therapeutic techniques, self-correcting, surmounting obstacles, leveraging opportunities, managing special situations, working with other systems of care, consulting other sources, and terminating therapy. Integral to the model is the integrated deep structure, which consists of 5 metacognitions: purposefulness, motivation, selection, sequencing, and timing.

Recovery-promoting professional competencies: perspectives of mental health consumers, consumer-providers and providers

OBJECTIVES

The purpose of this study was to empirically validate a set of conceptually derived recovery-promoting competencies from the perspectives of mental health consumers, consumer-providers and providers.

METHODS

A national sample of 603 consumers, 153 consumer-providers and 239 providers completed an anonymous survey via the Internet. The survey evaluated respondents' perceptions about a set of 37 competencies hypothesized to enhance clients' hope and empowerment and inquired about interactions with providers that enhanced clients' recovery process. We used descriptive statistics and ranking to establish the relevance of each competency and generalized linear models and post-hoc tests to examine differences in the consumers', consumer-providers' and providers' assessments of these competencies.

RESULTS

Analyses confirmed the recovery relevance of several competencies and their relative importance within each group of study participants. They also revealed that while most competencies tended to have universal significance, others depended more strongly on the client's preferences. Finally, differences in the perceptions of consumers, consumer-providers and providers about the recovery relevance of these competencies were established.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

The study highlighted the crucial role practitioners play in enhancing recovery from serious mental illnesses through specific strategies and attitudes that acknowledge clients' personhood and foster their hopefulness, empowerment and illness management. It informed the development of a new instrument measuring providers' recovery-promoting competence and provides guidelines for sharpening the recovery focus of a wide range of mental health and rehabilitation services.

Development and validation of competencies for return to work coordinators

INTRODUCTION

Return to work (RTW) coordinators are a key element in programs that facilitate RTW of injured or ill workers, yet little research documents the competencies required for success in this role.

METHODS

Competencies were defined as knowledge, skills, attitudes, and behaviors. Eight focus groups were conducted with 75 experienced RTW coordinators to identify 904 individual competencies. These were subsequently reduced to 234 unique items through affinity mapping, and sorted into eight groups: administration, individual personal attributes, information gathering, communication, professional credibility, evaluation, problem-solving, and conflict management. A subset of 100 items, including 88 items most often cited, were incorporated in an Internet-based survey that sampled a broad range of RTW coordinators from three countries.

RESULTS

Eighty-three of the questionnaire items were rated 4 or 5 (very important or essential) by over half of the 148 respondents. There were no differences in affinity group mean ratings by country, employer, profession, or type of clients. The highest-rated items reflect general personal characteristics, or specific skills related to coordinating among all involved with the RTW process. RTW coordinators with nursing backgrounds provided slightly higher ratings for items related to medical knowledge, but otherwise their ratings were similar to non-nurses.

CONCLUSIONS

These findings indicate a consensus across a wide range of RTW coordinators, and results can be applied to improve coordinator selection, training, and development. Certain key competencies may be well-established individual attributes, and others may be best developed through mentorship. Most of these competencies are probably best evaluated by direct observation.

From objectives to competencies: operationalizing the NONPF PMHNP competencies for use in a graduate curriculum

In the summer of 2004, the faculty in the psychiatric mental health nurse practitioner (PMHNP) Program at Oregon Health and Science University School of Nursing began the redesign of an objective-based curriculum to a competency-based curriculum. The competencies were based on the 2003 National Organization of Nurse Practitioner Faculties (NONPF) PMHNP competencies. This article describes the background and rationale for the curriculum redesign, the transition process, our resulting set of curriculum competencies, associated learning strategies, and some of the barriers and benefits we encountered. It is hoped that this and other articles describing the implementation of the NONPF PMHNP advance practice competencies will promote further dialogue and the development of best practices regarding competency-based education in advanced practice nursing.

Developing an integrated career and competency framework for diabetes nursing

AIMS AND OBJECTIVES

To describe the development of an integrated career and competency framework for diabetes nursing.

BACKGROUND

The UK Nursing and Midwifery Council provides a definition of competence, but the terminology used in relation to the subject is often ambiguous and confusing. These concepts are explored in relation to nursing practice and the different approaches to competency framework development are described. To work alongside the Royal College of Nursing (RCN) and Skills for Health competency initiatives, a Diabetes Nursing Strategy Group representing nurses working in diabetes care was formed to oversee the development of an integrated career and competency framework for diabetes nursing.

DESIGN

At the outset, the design was guided by the RCN Practice Development Team and employed qualitative methodology including the modified Delphi and nominal group technique.

METHODS

A purposive sample of nurses representing all sectors and grades of staff involved in diabetes care was invited to workshops to undertake a values clarification exercise. Content analysis was performed to identify themes. Further workshops identified areas of specialist practice and competence statements were developed and refined in a series of consultations.

RESULTS

Competence statements for a range of diabetes-related areas were produced for nurses at the levels of unregistered practitioners, competent nurses, experience/proficient nurses, senior practitioners/expert nurses and consultant nurses.

CONCLUSIONS

The description of the process of developing of the integrated career and competency framework should help other groups going through the same process. Relevance to clinical practice. In addition to helping groups identify a formula for the development of a competency framework, the framework itself is designed to provide a basis for educational programmes, personal career development and a tool for managers managing career progression within diabetes nursing.

Report of Recommendations: The Annapolis Coalition Conference on Behavioral Health Work Force Competencies

In May 2004, the Annapolis Coalition on Behavioral Health Workforce Education convened a national meeting on the identification and assessment of competencies. The Conference on Behavioral Health Workforce Competencies brought leading consumer and family advocates together with other experts on competencies from diverse disciplines and specialties in the fields of both mental health care and substance use disorders treatment. Aided by experts on competency development in business and medicine, conference participants have generated 10 consensus recommendations to guide the future development of workforce competencies in behavioral health. This article outlines those recommendations. A collaborative effort to identify a set of core or common competencies is envisioned as a key strategy for advancing behavioral health education, training, and other workforce development initiatives.