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

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Abstract

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.

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Acknowledgements

The authors wish to thank Ms. Paula Todd and Ms. Megan Anderson for their valuable insights into the search strategy.

Author information

Authors and Affiliations

  1. Department of Paramedicine, Monash University, Building H, McMahons Road, Frankston, VIC, 3199, Australia

    Alan M. Batt & Brett Williams

  2. Fanshawe College, 1001 Fanshawe College Blvd., London, ON, N5Y 5R6, Canada

    Alan M. Batt

  3. The Wilson Centre, Department of Medicine, University of Toronto/University Health Network, 200 Elizabeth Street, 1ES‑565, Toronto, ON, M5G 2C4, Canada

    Walter Tavares

  4. Post‑MD Education (Post‑Graduate Medical Education/Continued Professional Development), University of Toronto, Toronto, ON, Canada

    Walter Tavares

Authors
  1. Alan M. Batt
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  2. Walter Tavares
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  3. Brett Williams
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Correspondence to Alan M. Batt.

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Appendices

Appendix 1

See Table 7, 8.

Table 7 Search terms, dates, and number of results by database
Full size table
Table 8 Search terms, dates, and number of results—grey literature resources
Full size table

Appendix 2

See Table 9.

Table 9 Coding template with example
Full size table

Appendix 3: Citations for included studies

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Appendix 4

See Table 10.

Table 10 Characteristics of included studies
Full size table

Appendix 5

See Table 11.

Table 11 Rationale by profession
Full size table

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Batt, A.M., Tavares, W. & Williams, B. The development of competency frameworks in healthcare professions: a scoping review. Adv in Health Sci Educ 25, 913–987 (2020). https://doi.org/10.1007/s10459-019-09946-w

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