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

Batt, A. M.; Tavares, W.; Williams, B.

Background Competency frameworks serve many roles including outlining characteristics of a competent workforce, to provide clarity to complex constructs, to facilitate professional mobility, and to help structure analysis, evaluation or assessment of professional 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. Methods The Arksey and O'Malley framework was applied to undertake this scoping review. Six electronic databases (MEDLINE, CINAHL, PsycINFO, EMBASE, Scopus, and ERIC) and three grey literature sources (greylit.org, Trove and Google Scholar) were searched using keywords related to competency frameworks. Studies of all types were included that described the development of a competency framework in a healthcare profession. Studies were screened for inclusion, and data were extracted independently by two reviewers. Data synthesis was both quantitative and qualitative. Results Among 5,710 citations, 190 were selected for analysis. The majority of studies were conducted in medicine and nursing professions. Group techniques were utilised in 140 studies (74%), literature reviews were conducted in 112 (59%), and 81 (43%) outlined some form of stakeholder deliberation. We found 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, form, choice, sequence, combination, function, application and reporting of methods and strategies, there is no apparent gold standard or standardised approach to competency framework development. Conclusions This review observed significant variation within the conduct and reporting of the competency framework development process. Such variation is a cause for concern, potentially resulting in the development of frameworks that may not have captured the complexities of clinical practice, which are therefore of limited value to the profession, and may unwillingly create and legitimise artificial outcomes. The results of this review suggest there is a need for improved guidance in the process for developing and reporting competency frameworks.