Background

Competency frameworks for education, training and development are widely used in the health professions, including pharmacy. Published studies suggest that competency frameworks have an impact on professional performance. Professional performance that is consistent with up-to-date knowledge and skills influences health care quality and patient safety. This review assessed the effectiveness of competency frameworks in facilitating improvement in pharmacists’ performance.

Method

PubMed/Medline, CINAHL, Embase, ERIC, PsycINFO and Scopus electronic databases were searched to identify relevant literature. The findings of the included studies were synthesised qualitatively, and via a meta-analysis. The meta-analysis evaluated the odds of improved competency behaviour as a proxy measure of impact on pharmacists’ performance. Study quality was assessed using 12 criteria adapted from the EPPI-Centre guidelines v0.9.7. The protocol for this review is registered on PROSPERO with reference number CRD42018096580.

Results

In total, nine interventional studies were identified for review. The review findings showed observable and significant improvement in pharmacists’ performance when competency frameworks are used to appraise performance, identify knowledge gaps, and tailor learning activities. A meta-analysis that involved a total of 348 pharmacists undergoing repeat peer assessment showed pooled odds for improved competency behaviour of 4.41 (95% CI: 1.89–10.29, I² = 83%). Subgroup analyses showed pooled odds with corresponding 95% CI of 6.50 (1.77–23.97, I² = 77%) vs 2.95 (0.59–14.72, I² = 93%) for the studies that were conducted in countries within or outside Europe, respectively; 10.51 (3.73–29.62, I² = 24%) vs 2.39 (0.96–5.95, I² = 87%) for studies with reassessment conducted at ≤6 months from baseline, or more, respectively; 6.68 (1.63–27.45, I² = 88%) vs 2.80 (0.86–9.07, I² = 74%) for studies involving hospital or community pharmacists, respectively; and 2.80 (1.22–6.45, I² = 77%) for studies with low risk of bias.

Conclusion

These findings suggest competency frameworks facilitate improvement in pharmacists’ performance; however, further evaluative studies are needed.

中文翻译：

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药学相关能力发展框架的有效性和对绩效的影响：系统评价和荟萃分析

背景

教育、培训和发展能力框架广泛用于卫生专业，包括药学。已发表的研究表明，能力框架对专业绩效有影响。与最新知识和技能相一致的专业表现会影响医疗保健质量和患者安全。该审查评估了能力框架在促进药剂师绩效改进方面的有效性。

方法

检索了 PubMed/Medline、CINAHL、Embase、ERIC、PsycINFO 和 Scopus 电子数据库以识别相关文献。纳入研究的结果是通过荟萃分析定性合成的。荟萃分析评估了改进能力行为的几率，作为对药剂师绩效影响的替代衡量标准。使用改编自 EPPI-Centre 指南 v0.9.7 的 12 项标准评估研究质量。本次审查的协议在 PROSPERO 上注册，参考号为 CRD42018096580。

结果

总共确定了九项干预研究进行审查。审查结果表明，当使用能力框架来评估绩效、识别知识差距和定制学习活动时，药剂师的绩效有了可观察到的显着改善。一项涉及总共 348 名接受重复同行评估的药剂师的荟萃分析显示，改善胜任行为的综合几率为 4.41（95% CI：1.89–10.29，I ²  = 83%）。亚组分析显示， 在欧洲境内或境外国家进行的研究的汇总比值与相应的 95% CI 分别为 6.50 (1.77–23.97, I ²  = 77%) 和 2.95 (0.59–14.72, I ² = 93%) ; 10.51 (3.73–29.62, I ²  = 24%) vs 2.39 (0.96–5.95, I ² = 87%) 对于在距基线≤6 个月或更长时间内进行重新评估的研究； 涉及医院或社区药剂师的研究分别为6.68 (1.63–27.45, I ²  = 88%) 和 2.80 (0.86–9.07, I ² = 74%)；2.80 (1.22–6.45, I ²  = 77%) 用于低偏倚风险的研究。

结论

这些发现表明，能力框架有助于提高药剂师的绩效；然而，还需要进一步的评估研究。