Development of the competency scale for primary care managers in Thailand: Scale development

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.

The development of an instrument to measure interprofessional collaboration competency for primary care teams in the district health system of health region 2, Thailand

BACKGROUND

Evidence shows that interprofessional collaboration (IPC) practice contributes to the quality of health care. However, there are limited instruments to assess IPC in providing primary care in the district health system (DHS) in Thailand. The aim of this study is to develop a valid and reliable instrument to assess the IPC competency of primary care team members in DHSs.

METHODS

This study was designed as an exploratory mixed methods study. In the qualitative phase, 37 participants, including policymakers, practitioners, and academics with experience in primary care, were involved. Data were analysed using thematic analysis, and trustworthiness was verified by triangulation and peer debriefing. In the quantitative phase, content validity, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and reliability were conducted, and the final version of the questionnaire was evaluated with 497 participants.

RESULTS

The findings showed an I-CVI range of 0.86-1.00 and S-CVI/UA = 0.87 for 49 items with a 5-point Likert scale. EFA suggested six factors: 1) collaborative teamwork, 2) population- and community-centred care, 3) communication and mutual respect, 4) clarification of roles and responsibilities, 5) interprofessional reflection, and 6) interprofessional values and mixed skills. In the CFA results, the model fit indices were acceptable (CFI = 0.99, RMSEA = 0.049, SRMR = 0.043) or slightly less than the goodness-of-fit values (GFI = 0.84). All subscales showed acceptable Cronbach's alpha values with a range of 0.86-0.94.

CONCLUSIONS

The developed IPC competency instrument was confirmed its validity and reliability that contributes to assessing the IPC competency of primary care teams in DHSs. This information provides evidence to support tailored intervention to promote the IPC competency of primary care team work to achieve a common goal.

Assessment of competencies in the prevention and control of chronic diseases and their influencing factors among health assistants in Bhutan: a cross-sectional study

Background

The morbidity and mortality of chronic diseases are increasing worldwide. The literature confirms that the prevention and control of chronic disease necessitates a robust primary health care system with a competent health care workforce. Studies on competencies in the prevention and control of chronic diseases and their determinants among health assistants (HAs) in Bhutan are scarce. This cross-sectional survey aimed to examine the level of competencies and investigate the factors influencing competencies in the prevention and control of chronic diseases among HAs.

Methods

The sample consisted of 330 HAs who were recruited through simple random sampling. A validated and reliable self-administered questionnaire was used to collect data through a web-based Google Form. Data were analysed using descriptive statistics and multiple regression analysis.

Results

The findings showed that the mean summed competency score was 191 (SD = 25.7). Approximately 96% of the participants perceived that they were competent in the prevention and control of chronic diseases. The multiple regression analysis indicated that work environment (β = 0.473), sex (β = 0.126), location of the health facility (β = − 0.114), and organizational support (β = 0.117) affected competencies in the prevention and control of chronic diseases by 31.4% with statistical significance (R² = 0.314) (p < 0.05).

Conclusions

This study suggested that improving the number of staff and availability of learning resources, considering training for both sexes, especially female primary health care workers, enhancing mentorship and supervision in rural areas, and establishing the recognition and encouragement of primary health care workers are needed.

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.

Leadership and Management Competencies for Hospital Managers: A Systematic Review and Best-Fit Framework Synthesis

OBJECTIVE

Competent managers are vital to the productivity and service quality of healthcare organizations and the sustainability of the healthcare system. To improve their management competence, understanding of management competency requirements is important. The purpose of this study was to synthesize the evidence related to the leadership and management competencies in healthcare organizations through the best-fit method.

METHODS

A systematic review of literature published between 2000 and 2020 was performed to identify studies focusing on confirming and/or identifying the competency requirements of hospital managers. The best-fit framework synthesis method was used to map the identified competencies and associated behavioral items against the validated management competency assessment program (MCAP) management competency framework.

RESULTS

Twelve studies were identified for inclusion in the review. The mapping of the identified competencies and behavioral items generated a competency model for hospital managers that can apply for different healthcare context. The new competency model includes the following seven core leadership and management competencies: evidence-informed decision-making, operations, administration and resource management, knowledge of healthcare environment and the organization, interpersonal, communication qualities and relationship management, leading people and organisation, enabling and managing change, and professionalism.

CONCLUSION

This review and the mapping of the competencies identified in previous studies against the validated MCAP framework has resulted in the recommendation for an extended leadership and management competency framework for health service managers. It provides guidance for the formulation of training and development directions for the health service management workforce in a different healthcare context.

Alignment of Perceived Competencies and Perceived Job Tasks among Primary Care Managers

In this study we aimed to explore how managers in primary health care (PHC) organizations assess their managerial knowledge and skills, as well as the importance of these competencies for their job, and to identify whether there is an alignment between these two perceptions; therefore, whether there is a need for management competency improvement. With this study, we tried to address a high demand for information about health managers, especially in health systems in low- and middle-income countries. In a sample of 58 primary health care centers (n = 106 managers) in Serbia, we used a basic managerial competency matrix consisting of the following six competencies—communication, team-building, planning and priority-setting, performance assessment, problem-solving, and leading. Managerial perception of the importance of their job tasks differs by educational level and managerial position. The best alignment between the importance of knowledge and skills was for communication and leading. The study pointed out that managers were aware of the necessity to improve their level of managerial competencies, particularly in the domains of planning and priority-setting, performance assessment, and problem solving. The study highlights the need for formal managerial education for managers in PHC settings and commitment to continuously evaluate and improve management competencies in order to better manage PHC.

Testing psychometric properties of a new instrument 'Promoting Active Ageing in Older People with Mental Disorders Scale' from a cross-sectional study

BACKGROUND

There is no instrument that measures the promotion of active ageing or the factors that influence the promotion of active ageing in older people with mental disorders living in the community. This study aimed to examine psychometric properties of a new survey instrument.

METHODS

A mixed methods exploratory sequential design was used incorporating a cross-sectional survey. The Promoting Active Ageing in Older People with Mental Disorders Scale (PAA-MD) was sent to 579 primary care providers in Yasothon province, Thailand. Construct validity was tested using exploratory factor analysis. The internal reliability was examined using Cronbach's alpha coefficient.

RESULTS

The PAA-MD consisted of three sections. Section II found Bartlett's test of sphericity was χ² (1431) = 26221.167, P < 0.001. Items used theoretical justification to group items into five factors, namely: participation, education, health, leisure, and security. Section III indicated Bartlett's test was χ² (666) = 23524.074, P < 0.001. Items were grouped into five components, namely: facilitators, barriers, knowledge, skills, resources and support. Internal reliability of sections II and III with Cronbach's alpha was greater than 0.7. The corrected item-total correlation coefficient of all items was greater than 0.30.

CONCLUSION

The PAA-MD contains 104 items from three sections. Construct validity was adequate to capture phenomena. Internal reliability revealed good homogeneity.

Assessment of professional competence of nurses in emergencies: created and validated instrument

ABSTRACT Objective: To create an instrument to assess the professional competence of nurses in emergencies. Method: Methodological study carried out between 2013 and 2016 in a Brazilian university. We used the Pasquali's model and Psychometrics as references because they allow subjective phenomena to be measured. The survey covered defining steps of the behavior to be measured, the formulation of the items in the instrument, development of instructions for using the instrument and elements necessary to demonstrate validity evidence. Although we have previously performed, in a distinct and consecutive way, the literature review, definition of the Core (or Matrix) Competence and the Competence Profile, and identification of validity with Delphi, essential components to structure a technology, in this step we continued the conclusion of these Theoretical Procedures. Result: We created an instrument for self- and/or hetero-evaluation containing: personal/professional/academic characterization, Competency Scale, fictitious cases and actions representing the practice. Conclusion: We created a new soft-hard technology based on the validity evidence of contents according to experts of the five regions of Brazil.

A Leadership and Managerial Competency Framework for Public Hospital Managers in Vietnam

Objective

The aim of this paper was to develop a leadership and managerial competency framework for public hospital managers in Vietnam.

Methods

This mixed-method study used a four-step approach. The first step was a position description content analysis to identify the tasks hospital managers are required to carry out. The resulting data were used to identify the leadership and managerial competency factors and items in the second step. In the third step, a workshop was organized to reach consensus about the validity of these competency factors and items. Finally, a quantitative survey was conducted across a sample of 891 hospital managers who are working in the selected hospitals in seven geographical regions in Vietnam to validate the competency scales using exploratory factor analysis (EFA) and Cronbach's alpha.

Results

The study identified a number of tasks required for public hospital managers and confirmed the competencies for implementing these tasks effectively. Four dimensions with 14 components and 81 items of leadership and managerial competencies were identified. These components exhibited 83.8% of variance and Cronbach's alpha were at good level of 0.9.

Conclusions

These competencies are required for public hospital managers which provide guidance to the further development of the competency-based training for the current management taskforce and preparing future hospital managers.