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Abstract
Objectives This study examined the risks and supports to competence discussed in the literature related to occupational therapists, pharmacists, physical therapists and physicians, using epidemiology as a conceptual model.
Design Articles from a scoping literature review, published from 1975 to 2014 inclusive, were included if they were about a risk or support to the professional or clinical competence of one of four health professions. Descriptive and regression analyses identified potential associations between risks and supports to competence and the location of study, type of health profession, competence life-cycle and the domain(s) of competence (organised around the CanMEDS framework).
Results A total of 3572 abstracts were reviewed and 943 articles analysed. Most focused on physicians (n=810, 86.0%) and ‘practice’ (n=642, 68.0%). Fewer articles discussed risks to competence (n=418, 44.3%) than supports (n=750, 79.5%). The top four risks, each discussed in over 15% of articles, were: transitions in practice, being an international graduate, lack of clinical exposure/experience (ie, insufficient volume of procedures or patients) and age. The top two supports (over 35%) were continuing education participation and educational information/programme features. About 60% of all the articles discussed medical expert and about 25% applied to all roles. Articles focusing on residents had a greater probability of reporting on risks.
Conclusions Articles about physicians were dominant. The majority of articles were written in the last decade and more discussed supports than risks to competence. An epidemiology-based conceptual model offers a helpful organising framework for exploring and explaining the competence of health professions.
- competence
- health professions
- risks
- supports
- epidemiology
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Footnotes
Contributors SGT, MN and LMMS made substantial contributions to the conception and design of this work, as well as the analysis and interpretation of data for this work; helped draft and critically revise the manuscript and gave final approval of the version to be published. All authors agree to be held accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Funding This work was supported by unrestricted educational grants received from the College of Physicians and Surgeons of Alberta (CPSA) and the College of Physicians and Surgeons of Ontario (CPSO) in 2014. The funding sources had no involvement in study design, data collection, analysis, synthesis or manuscript review and approval.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement If readers are interested in the complete inventory of articles on each risk and support to competence, or any other study data, please contact the corresponding author.