Core Competencies: The Next Generation Comparison of a Common Framework for Multiple Professions

Journal of Allied Health, Spring 2009 by Verma, Sarita LLB, MD, CCFP, FCFP, Broers, Teresa MSc, Paterson, Margo PhD, OT Reg (Ont), Schroder, Cori MD, MEd, CCFP, FCFP, Medves, Jennifer M PhD, RN, Morrison, Carole BA

This report demonstrates the application of a competency model to the regulated and unregulated professions of medical radiation technology, social work, pharmacy, and psychology. The competency model is based on the CanMEDS framework and was originally applied to the professions of medicine, occupational therapy, physical therapy, and nursing in an earlier work. The framework identifies the core competencies common to learners in health care, which are professional (and health advocate), expert, scholar, manager, communicator, and collaborator. In this repon, these core competencies are applied to four additional disciplines in an effort to make the cultural shift from discipline-based silos to a common language for ascertaining the skills, knowledge, and attitudes needed to function in interprofessional teams. J Allied Health 2009; 38:47-53.

HEALTH CANADA, through its Interprofessional Education for Collaborative Patient-centred Practice Initiative, spear- headed several initiatives that sought to change the way health care providers are educated by ensuring that providers have the necessary knowledge and training to work effectively in interprofessional teams.1 As a result, innovative interpro- fessional education activities have been planned and imple- mented for health care learners in colleges and universities across Canada. An earlier report2 identified the core competencies common to learners in medicine, nursing, occupational therapy, and physical therapy that could be used to facilitate the integration of educational curricula for interprofessional education across the faculty of health sciences at one Canadian university. Improved understanding of the common core competencies also met the expressed desire of teaching faculty to have a shared vocabulary and better understanding of objectives, expectations, and standards across different health care professions. The resulting harmonized core competency model represented a set of descriptors that are comparable on the horizontal plane and can facilitate cross-pollination of skills among the four professions. The report further suggested that the model could he extrapolated to other health professions, which include regulated as well as unregulated professions. Social work is an example of an unregulated health profession; social workers are integral to every health care team, given the realities of short-term stay, discharge planning, and access to social support services.

Thus, based on the harmonized core competency model for medicine, nursing, occupational therapy, and physical therapy, the aim of this study was to apply the model to the core competencies identified in medical radiation technology, social work, psychology, and pharmacy. These professions were chosen primarily because of their critical roles in the hospital in general and on interprofessional teams in particular.

Defining Core Competency

Core competencies are a valuable concept for comparing the responsibilities of various professionals. The idea behind identifying core competencies and sharing them across the continuum of health care practice is fourfold:

1. Inform ream members so they will be able to cross boundaries that separate professionals from one domain to another

2. Develop curricula to educate the learner to work more collaboratively and more respectfully with patients and other health care providers and to push the boundaries of their job in the context of holistic care

3. Alert the government and academics who can change how systems fund, regulate, appraise, and sustain effective frontline practice

4. Promote a new, more integrated and consistent way of thinking about knowledge, practice, program design, and policy in interprofessional education.

Competence is a multifaceted and dynamic concept that refers to the understanding of knowledge, clinical skills, interpersonal skills, problem solving, clinical judgment, and technical skills by the different professions.2 In health care, competencies are generally used to define professional and specialty standards and expectations and to align practitioners, learners, teachers, and patients with evidencebased standards of health care and performance.2

All professional colleges and associations provide standards and guidelines for their members that reflect the knowledge, skills, and judgment that a professional requires to perform specific services and procedures. These guidelines may be labeled in various ways - codes of ethics, comprehensive guidelines, standards of professional conduct, standards of practice, and/or essential competencies - but all refer to the essential responsibilities and competencies required of the professionals in question.

Core competencies represent a set of skills, knowledge, and attitudes necessary for the comprehensive practice of clinical care. They transcend the boundaries of the specific professions and give important transparency to clinical teams to minimize errors and enhance patient outcomes and safety. A unit of competency is a component of a competency standard and is a statement of a key function or role in a particular job or occupation.' We suggest that many units are the same for many professions and thus can he translational for team-based assessments between and among health care teams. Health care teams are generally defined as a group of diverse clinicians who communicate (either face to face, virtually, through charts, and so on) with each other about the care of a defined group of patients and participate in that care.4