Inventory and description of all study variables and of the risks to competence and supports to competence identified in the literature
| Area | Risk/support category | Description |
| A. Type of health profession | Physician | One of four health professions in study. Other words for this profession include ‘doctor’ and ‘medical doctor’. Refers to individuals at any stage of the physician competence life-cycle (eg, medical student, resident, practising physician) |
| Other health professions (eg, dentists and nurses) | Other health professions were only included when the study also discussed one or more of the four professions of primary interest. | |
| Pharmacist | One of four health professions in study | |
| Occupational therapist | One of four health professions in study | |
| Physical therapist | One of four health professions in study Another word for this profession is ‘physiotherapist’. | |
| B. Competence life cycle | Practice | Working in the health field as an autonomous practitioner |
| Resident | Postprofessional education of physicians, called residency education or graduate medical education, leading towards a certification or specialty designation; If education of another profession was not postprofessional, it was considered field- based education. | |
| Field-based education | The practical education of one or more of the health professions of interest; includes clinical-based training for physiotherapists and clerkship or internship education for physicians | |
| Other | Articles where the competence life-cycle was not specifically mentioned | |
| C. CanMEDS roles15 | Medical expert | Demonstrating clinical knowledge, skills and abilities required for effective patient care. |
| Communicator | Communicating with patients and providing appropriate written documentation. | |
| Professional | Demonstrating ethical practice, high personal standards of behaviour, accountability to the profession and society, profession-led regulation and maintenance of personal health. | |
| Scholar | Demonstrating commitment to life-long learning, utilising evidence-informed decision-making, teaching and research | |
| Collaborator | Working effectively with other health professions including teamwork, managing differences and resolving conflict | |
| Manager | Managing time, resources and priorities, including supervision of learners | |
| Health advocate | Advocating for care or services for individual patients, the community or the patient population | |
| D. Risks to competence | Transitions | Dyscompetence or differences in performance associated with change(s) in work or professional status, in focus of practice and/or as experienced by new graduates |
| International graduate | Dyscompetence or differences in performance associated with health professionals that were educated in a different country than where the study took place | |
| Lack of clinical exposure/experience | Dyscompetence or differences in performance associated with knowledge/competence gaps in certain clinical areas arising from insufficient volume of procedures and patients with a particular condition to attain or maintain competence | |
| Age | Dyscompetence or differences in performance associated with the person’s age including youth and older age | |
| Gender | Dyscompetence or differences in performance between men and women | |
| Practice features | Dyscompetence or differences in performance associated with geographical or office features of the practice | |
| No certification | Dyscompetence or differences in performance associated with presence/absence of specific specialty certification | |
| Wellness | Dyscompetence or differences in performance associated with physical or mental health related issues | |
| Resources | Dyscompetence or differences in performance associated with resources, including people, money and time | |
| Adequacy of practice or education | Dyscompetence or differences in performance associated with a previous educational programme that did not adequately prepare learners with particular skills or with specific knowledge due to brevity or low quality | |
| Area of specialty/certification | Specialty or certification-based variations in dyscompetence; certification and specialty are often used interchangeably | |
| Previous disciplinary activity | Impact of previous complaint or discipline matter by a regulatory authority, specialty organisation or health facility on dyscompetence | |
| Other | Differences related to risks to competence not included in the higher-volume defined topics | |
| E. Supports to competence | Continuing education participation | Involvement in an educational activity such as a course, workshop or conference during the practice competence life-cycle (ie, postspecialty/programme-specific training) |
| Educational information/programme features | Actions or interventions included in a pre-existing educational programme that are designed to improve the learning, knowledge translation and application of the material | |
| Personal support and feedback | Mentorship and feedback provided or available to individuals to inform or improve clinical skills and/or knowledge | |
| Adequate clinical exposure/experience | Time spent in specific rotations or at specific clinical sites, with a particular patient/client population. | |
| Quality assurance participation | Formal activities within a structured organisational quality assurance programme, in the workplace | |
| Support through structure or organisation | Employer or site-specific structures or processes that develop or maintain individual or professional competence | |
| Professional organisation participation/systems | Mandatory participation in formal personal activities to develop or maintain competence as established through regulatory, association or specialisation requirements | |
| Technology | Mechanical or electronic means to develop or maintain competence via simulation, eLearning opportunities and electronic decision support rules | |
| Reflection and self- assessment | Approaches to developing or maintaining competence that include introspection, personal analysis and consideration of adequacy of competence or demonstration of competence | |
| Assessment and feedback through tools | Approaches that employed a specific tool to measure professional competencies to determine the adequacy of performance and/or to provide information and motivation for improvement | |
| Performance review | A formal or structured work-based process whereby a practitioner is provided with information on the adequacy of performance and/or provided with information and motivation for improvement; This information is generally formative and intended to assist in performance improvement. | |
| Other | Approaches to developing or maintaining competence not included in other high-volume defined topics. |