In light of the cancellation of the Canadian Conference on Medical Education which was due to be held in Vancouver in April 2020, here are the two abstracts (with posters) that I was due to present. In addition, all accepted workshops, orals and posters will be published in the Canadian Medical Education Journal (link to follow here once published). Images and PDFs of the posters are available below each abstract.
A ‘systems thinking’ conceptual framework to explore clinical practice.
Alan Batt, Brett Williams, Madison Brydges, Matthew Leyenaar, Walter Tavares
The nature of clinical practice is ever-changing, varies according to the attributes of those enacting it, and poses complex questions that must be considered within context. As such, healthcare professionals need the ability to understand and respond to the larger contexts of the healthcare system. Existing approaches to describing clinical practice may be limited in how they conceptualize such context and complexity.
We sought to evaluate how conceptualization of paramedic practice may be optimized using a systems approach. We examine the role of combining an adaptation of Ecological Systems Theory (EST) and complexity thinking as ways of describing paramedic practice.
EST can be adapted to outline the elements of clinical practice. This obligates a focus on various healthcare system levels which are often missing from our descriptions of practice. Complexity thinking obligates a focus on the non-linear, unpredictable nature of relationships between these elements. When combined, these frameworks allow for identification of elements within the system that may have value in describing clinical practice. We illustrate how aspects of paramedic practice may be ignored until viewed from a merging of these approaches.
Merging EST with complexity thinking provides an opportunity to reflect the complex realities of clinical practice when attempting to describe it. This conceptual framework promotes a focus on factors from macro level to individual patient level, as well as on the relationships within the system. This can be used as a foundation to inform future efforts to represent clinical practice, such as in the development of competency frameworks.
How do healthcare professions develop competency frameworks?
Alan Batt, Walter Tavares, Brett Williams
Competency frameworks serve many roles including outlining characteristics of a competent workforce, facilitating professional mobility, and structuring curriculum and assessment. Given their significance in health professions, we sought to understand the strategies used in the development of existing competency frameworks.
We conducted a scoping review using the Arksey and O’Malley framework. Six electronic databases and three grey literature sources 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 independently by two reviewers. Data synthesis was both quantitative and qualitative.
190 citations were selected for analysis. The majority of studies were conducted in medicine and nursing. We found a significant degree of diversity in methodological strategies, and inconsistent adherence to existing (albeit limited) guidance on framework development. Based on the variation we observed in choice, sequence, application and reporting of methods and strategies, there is no apparent standardised approach to competency framework development
Significant variation exists in the processes used to develop competency frameworks. Adherence to existing guidelines is inconsistent. This raises questions about which processes are fit for purpose and whether resulting competency frameworks capture the complexities associated with clinical practice, the value or completed frameworks to the corresponding profession, and whether existing processes lead to unintended but legitimized artificial outcomes. Guidance in competency development processes may need to be revisited