Core Competency Areas Research Articles

Core Competencies of the Entrepreneurial Leader in Health Care Organizations

The purpose of this article is to discuss core competencies that entrepreneurial health care leaders should acquire to ensure the survival and growth of US health care organizations. Three overlapping areas of core competencies are described: (1) health care system and environment competencies, (2) organization competencies, and (3) interpersonal competencies. This study offers insight into the relationship between leaders and entrepreneurship in health care organizations and establishes the foundation for more in-depth studies on leadership competencies in health care settings. The approach for identifying core competencies and designing a competency model is useful for practitioners in leadership positions in complex health care organizations, so that through the understanding and practice of these 3 areas of core competencies, they can enhance their entrepreneurial leadership skills to become more effective health care entrepreneurial leaders. This study can also be used as a tool by health care organizations to better understand leadership performance, and competencies can be used to further the organization's strategic vision and for individual improvement purposes.

Continuity-Structured Clinical Observations: Assessing the Multiple-Observer Evaluation in a Pediatric Resident Continuity Clinic

The continuity-structured clinical observation tool was developed and used to conduct a multiple-observer evaluation to assess residents in the core competency areas of patient care, interpersonal and communication skills, and professionalism. The objectives were to assess pediatric resident performance in a continuity clinic by using direct observation and to compare evaluations among preceptors, residents, and parents. Pediatric residents in a large continuity clinic participated between August and December 2005. The continuity-structured clinical tool included items in the following domains: opening the interview, history taking, relationship skills, personal manner, negotiation or management, and physical examination. Each resident was directly observed during 1 entire patient encounter. Parents, preceptors, and residents completed evaluations by selecting 1 of 4 possible responses for performance of each item. We dichotomized responses as "yes" versus "no/partial" and analyzed aggregate scores for individual items and domains among the 3 evaluators by McNemar test, percentage agreement, and interoberserver agreement (kappa). Fifty-four of 57 eligible residents had all 3 evaluations completed. Parents rated residents the highest and showed least variability (only 2 items for which parents indicated the task was completed in <90% of the encounters). Residents rated themselves the lowest (35 items with <90%). In comparing the residents and preceptors, the domains that had the lowest percentage of agreement were history taking (range: 61%-91%) and negotiation or management (range: 51%-88%). All of the evaluators scored residents the lowest in the domain of negotiation or management, with the following lowest-score items: probe for decision-makers, assess willingness and barriers, and use of visual aids. Compared with parents, residents and preceptors demonstrated greater variability in resident performance evaluations. All of the evaluators scored residents lowest in the domain of negotiation or management during continuity-clinic visits. Residency programs should strongly consider emphasizing skill development in this area.

Quality improvement in fellowship training programs: The pilot quality oncology practice initiative (QOPI) project

17523 Background: Oncology fellowship programs train physicians in many core competency areas, one of which is practice-based learning and improvement. In spring 2007, Virginia Commonwealth University was among the first eight fellowship programs to participate in ASCO's Quality Oncology Practice Initiative (QOPI). QOPI is a practice-based quality improvement (QI) program that provides a mechanism for self-examination and improvement. Fellowship programs participating in QOPI receive feedback comparing their performance with more than 100 U.S. community and academic practices. Methods: Six charts per fellow were selected from the fellows’ clinic according to QOPI methodology. Peers abstracted data using QOPI measures, and the information was included in the nationwide QOPI database from which a comparative report was provided. Results were discussed in a fellowship didactic. ASCO practice guidelines were reviewed and plans were developed to improve documentation. Results: The abstraction process alone resulted in meaningful discussion regarding cancer quality measures. The fellows’ clinic performed above average for almost all quality indicators both within the core quality measures as well as the breast cancer module. A few areas including documentation of the intent of treatment, following erythropoetin guidelines and the use of aprepitant were below average. In a brief survey, all fellows found QOPI to be helpful in learning QI, and considered it useful for current and future practice. Plans were made to participate in future QOPI data collections. Conclusions: QOPI provides a tool for practicing oncologists to assess the quality of care they provide, and fulfills many of the core competencies of fellow education. Providing fellows the opportunity to participate in QOPI establishes a pattern of quality improvement that may continue into future practice. It teaches fellows about peer review, and encourages dialogue about quality indicators in patient care. The next step will be to see if the educational intervention impacted the quality indicators on the fall 2007 QOPI data collection. No significant financial relationships to disclose.

Vice-principalship in Hong Kong: aspirations, competencies, and satisfaction

This article details a large-scale study of vice-principals in Hong Kong secondary schools. The study aimed to examine the core competency areas that pertain to the work of vice-principals and the way in which vice-principals perceive these areas to relate to school success. It also examined the factors that affect their level of job satisfaction, and differentiated these factors according to whether they did or did not aspire to principalship. The findings indicate that competency gaps, if large enough, can affect the level of job satisfaction of vice-principals and that the impact of these gaps varies according to career orientation. The results show that vice-principals who aspire to be a principal are more satisfied in their jobs than their less ambitious colleagues; and that the effect of these gaps on job satisfaction differs between the two groups. The implications of the findings for the future supply of principals and leader development are expounded.

A model for resource allocation using operational knowledge assets

PurposeThe paper seeks to develop a business model that shows the impact of operational knowledge assets on intellectual capital (IC) components and business performance and use the model to show how knowledge assets can be prioritized in driving resource allocation decisions.Design/methodology/approachQuantitative data were collected from 84 high‐tech federal contractors in the Washington DC metro area. Respondents in the target population were middle‐level and operations managers of business sectors holding positions as presidents, vice‐presidents, directors, engineering managers, operations managers, and analysts. Partial least squares (PLS) analysis was performed to develop a structural model between operational knowledge assets and IC components that maximizes explained variance for business performance. Operational assets were specified as formative constructs and IC and business performance were specified as reflective constructs.FindingsA parsimonious conceptually sound model with significant measured variables and path coefficients was developed that explains almost 40 percent of the variance in business performance. The model shows both the interrelationships between the IC components that drive performance and the operational assets as levers for each IC component, respectively.Research limitations/implicationsThe scope of the study was focused on the high‐tech federal contractors in the USA. However, the model can be applied and tested in different industry sectors. This would provide evidence of the different operational knowledge assets used as levers in different industry sectors.Practical implicationsSenior executives and chief financial officers in particular are constantly challenged with making the optimum investment decisions given their budget constraints. The model offers a tool for developing and evaluating different resource allocation decisions based on an organization's strategic intent. In addition, the model can be useful in evaluating merger and acquisition decisions. In evaluating target companies the model can be used to identify the core capabilities or competency areas that the target company is leveraging and assess the impact or integration potential for the acquiring company.Originality/valueThis is the first study in the field of IC that has adopted the use of formative indicators in specifying operational knowledge asset constructs. Previous research has focused on developing models with the use of proxy measures as reflective indicators. Therefore the emphasis so far has been on scale development. The use of formative items in this study fills both the business need and theory gap to understand better the causal relationships that exist between work and knowledge assets.

Preferences of Alaska and New Mexico Psychiatrists Regarding Professionalism and Ethics Training

To identify the preferences of practicing licensed psychiatrists in two rural states regarding ethics training. All licensed psychiatrists in Alaska and New Mexico were mailed a survey exploring differences in ethical and practice issues between rural and urban health care providers. Data were collected from 97 psychiatrists. Findings indicated a moderate level of interest in training related to a diverse set of ethics topics. Although women expressed greater interest in most topics than did men, ranking of topics was similar across genders. Level of interest in training was inversely related to number of years in practice. The psychiatrists in this study indicated some interest in professionalism and ethics training, but did not express the level of need or enthusiasm documented in many studies of physicians-in-training. Creating continuing medical education initiatives that are attuned to the distinct needs and preferences of psychiatrists in clinical practice thus poses many challenges. This may be particularly true for certain aspects of practice, such as ethics and professionalism, that have long been recognized as vital to clinical care, but now are viewed as core competency areas.

Core competencies for the acquisitions librarian

Position announcements for acquisitions-related jobs were analyzed to determine what knowledge and skills were sought by employers in 1999, 1987, and 1975. The competencies identified from the position announcements were compared with other input regarding competencies for acquisitions and collection development work, and a good deal of similarity was found to exist. From this, a list of core competency areas is presented.

Notes on Professional Practice: Issues in Service Delivery for Guidance Officers

About eight years ago I co-wrote a paper on guidance officer training in Victoria which argued that guidance officers required training in six core competency areas. There were identified as assessment, counselling, research, educational consultancy, systems intervention, and professional practice.At the time, the intent was to argue for a broader training for guidance officers rather than the traditional focus on issues of assessment and counselling. It was recognising an international trend in service delivery from individual casework models to those which incorporated consultancy and direct classroom interventions. The paperwas arguing fora comprehensive training program which supported guidance officers and gave them the skills and strategies required to make this shift.