Core Competencies for Health Care Professionals: What Medicine, Nursing, Occupational Therapy, and Physiotherapy Share

Journal of Allied Health, Summer 2006 by Verma, Sarita, Paterson, Margo, Medves, Jennifer

This paper describes the amalgamation of the core competencies identified for medicine, nursing, physical therapy, and occupational therapy and the "harmonization" of these competencies into a framework tor interprofessional education. The study was undertaken at a Canadian university with a Faculty of Health Sciences comprised of three schools (namely, medicine, nursing, and rehabilitation therapy). Leaders in interprofessional education began to identify the common standards for the core competencies expected of learners in all three schools at commensurate levels to facilitate the integration of educational curricula aimed at interprofessional education across the Faculty. The model that was created serves as a basis for curriculum design and assessment of individuals and groups of learners from different domains across and within the four professions. It particularly highlights the relevance of cross-disciplinary competency teaching and 360-degree evaluation in teams. Most importantly, it provides a launch pad for clarifying performance standards and expectations in interdisciplinary learning. J Allied Health 2006; 35:109-115.

WHILE IN THE EARLY STAGES of creating an academy of educators skilled at teaching and evaluating interprofessional practice and education at a Canadian university, two needs emerged as crucial to the success of a change in culture in academic health sciences, namely: 1) to identify the common standards for the core competencies expected of learners in all three schools at commensurate levels and 2) to develop and evaluate a curriculum that can he delivered at the appropriate levels and with appropriate standards for the four professions in the faculty. These critical issues arose out of the expressed desire of teaching faculty to have a shared vocabulary and better understanding of objectives, expectations, and standards in their health care professions.

Consensus emerged that a logical place to begin would be with a description of the vital competencies required tor the four professions. This paper describes the amalgamation of the core competencies identified for medicine, nursing, physical therapy, and occupational therapy and the 'harmonization' of these competencies into a framework for interprofessional education.

Background

Core competencies were developed in the 1980s, at a time when public interest in health care was growing and expectations of society were evolving dramatically to account for professionalism. Key events in the evolution of core competencies have included: 1) the development of expectations of the accrediting colleges, with a movement toward mandatory teaching and evaluation of these competencies; 2) curricular change requiring interprofessionalism and collaboration among the health care disciplines; 3) shortages in all health care specialties, forcing innovations in health care delivery and changes in the scope of practice; and 4) the introduction of concepts of team-based and managed care into education including of primary health care reform.

The competencies outlined in this article describe the values, knowledge, attitudes, and skills that each profession has identified as essential. Many of these competencies reaffirm the social contract between the public and the practitioner. They reflect the legal, ethical, regulatory, and political influences on the practice of interprofessional health care.

What is a Competency and Why is it Important?

Competence is a multifaceted and dynamic concept that is more than knowledge and includes the understanding of knowledge, clinical skills, interpersonal skills, problem solving, clinical judgment, and technical skills.1 In this paper, competence is viewed as a behavior or set of behaviors that describe excellent performance in a particular work context (e.g., job, role, or group of jobs, function, or whole organization). In health care, competencies are used to define discipline and specialty standards and expectations and to align practitioners, learners, teachers, and patients with evidence-based standards of health care and performance. Competencies in education create an environment that fosters empowerment, accountability, and performance evaluation which is consistent and equitable. The acquisition of competencies can be through talent, experience, or training. A competency model is a set of success factors that include the key attributes required for excellent performance in a particular role.

The identification of competencies and the models for their implementation are key in health care education, as they reinforce interprofessional health care culture, and vision. By enforcing competencies, health care professionals establish expectations for performance excellence, resulting in a systematic approach to professional development, improved job satisfaction, and better learner performance. Competency models increase the effectiveness of training and educational programs by linking them to defined criteria. They also provide data on evaluation and consistency, as health care learning occurs in a context of outcome of multirater assessments.