Core Competency Areas Research Articles

Identifying core competency areas to assess communication skills among interns at a tertiary teaching hospital in southern India.

We aimed to develop a teaching-learning and evaluation programme on communication skills for interns. Core competency areas for focused communication skills training and assessment were identified to achieve the obective. We then assessed the identified competencies among interns using objective structured clinical examination (OSCE), before the start of internship. Five core areas for focused training and evaluation were identified on the basis of responses of practising physicians in local settings. OSCE stations were developed for evaluation based on the identified competency areas. A pre-test OSCE was administered to 30 interns. Five core areas selected for training and evaluation were: (i) communicating with a parent resistant to immunization; (ii) interacting with a patient who has psychosomatic complaints; (iii) explaining risks and procedures; (iv) breaking bad news; and (v) communicating with patients and bystanders in a casualty setting. Thirty of 160 interns were selected to participate in the OSCE before the training (pre-test). The lowest score was for breaking bad news. Scores indicated that explaining risks and procedures, communicating in a busy casualty setting and dealing with psychosomatic complaints were areas that required extensive training and practice. We were able to identify core competency areas for focused training and evaluation of communication skills suited to the local context and used OSCE to evaluate the skills before the start of internship.

Teaching Resident Self-Assessment Through Triangulation of Faculty and Patient Feedback

ABSTRACTProblem: To accurately determine one's ability in any clinical competency, an individual must be able to self-assess performance and identify personal limitations. Existing research demonstrates that physicians of all levels are unreliable self-assessors. This poses a concern in medical practice, which requires continuous updates to clinical competencies and awareness of personal limitations. Few published studies examine graduate medical education curricula designed to develop self-assessment skills. Intervention: Conceptual models, such as self-determination theory, suggest that self-assessment is most effectively learned through reflective processes. The Family Medicine Residency Program at Lehigh Valley Health Network developed a learner-centered competency assessment process that integrates advising and performance review. The multisource, observable behavior-based process encourages conversation between resident and advisor. Utilizing feedback from clinical preceptors and patient surveys, advisors guide residents in determining individual learning needs in core competency areas, including relationship-centered care. Development of medical learners' capacity to form relationships is one means to improving the patient experience. Context: This retrospective case study evaluates the accuracy of senior residents' self-assessment in relationship-centered care compared with that of junior residents. The study population includes the 34 residents enrolled from AY 2009–2012. Data sets represent specific 6-month periods and have 3 component scores—Self, Faculty, and Patient—which were triangulated to determine concordance rates by postgraduate year level. Outcome: The concordance rate among first-years was 26.7%, whereas third-years saw 60.0% concordance. A discordance analysis found the Patient score most often deviated from the other 2 scores, whereas the Faculty score was never the sole dissenter. When all 3 scores differed, the Self score frequently fell between the other 2 scores. Lessons Learned: The principles of self-determination theory provide a valuable framework for understanding the development of residents' intrinsic motivation to become lifelong learners. The trend in improved concordance rates among senior residents suggests that prompting learners to triangulate feedback from multiple sources can lead to a shift in perspective about competency. Further study is needed to determine whether our results are generalizable to other competencies and educational settings.

AAVP Recommendations for Core Competency Standards Relating to Parasitological Knowledge and Skills.

As part of the accreditation process, the American Veterinary Medical Association Council on Education has defined nine broad areas of core competencies that must be met by graduating students earning a Doctor of Veterinary Medicine degree. To define competencies in veterinary parasitology, the American Association of Veterinary Parasitologists (AAVP) has developed a detailed list of knowledge and skills that are recommended for inclusion in professional curricula. These recommendations were developed by instructors from colleges/schools of veterinary medicine in the US, Canada, and the Caribbean, and were reviewed and endorsed following AAVP guidelines.

Catalyzing Aid? The IMF and Donor Behavior in Aid Allocation

The International Monetary Fund (IMF) has often asserted that its programs encourage aid by signaling policy credibility, commonly referred to as aid catalysis. Our study investigates this claim for sector-specific aid and for bilateral and multilateral donors using data on 136 recipient countries for the 1986–2009 period. We employ a two-part quantitative model to match the donor decision-making process, consisting of a first-stage recipient selection equation and a second-stage allocation equation on selected recipients. We find strong support that IMF programs catalyze aid on aggregate, but the evidence varies across different types of aid. Aid catalysis is stronger and more robust in sectors linked to the IMF’s core competency areas, namely debt-related relief and general budget support, but weaker and less robust for infrastructure, production, multisector, and humanitarian aid, and non-existent for health and education. Across donors, IMF programs are associated with increases in aid by countries with larger voting shares in the IMF, such as the United States and Japan, but less so by countries with few votes or for multilateral agencies. This finding is consistent with research in international political economy arguing that the IMF’s powerful stakeholders drive the organization’s decisions and policies. Taken together, our findings emphasize the IMF’s multi-dimensional impact on the global development agenda—an erstwhile overlooked factor in studies of aid allocation—while refuting the purported positive effects of IMF programs on aid for social policy.

Cultural Core Competencies: Perceptions of 4-H Youth Development Professionals

As society grows increasingly diverse, it is critical that youth development professionals are equipped with cultural core competencies. This descriptive study gauged the perceived level of cultural competence among 4-H Youth Development professionals from a Southern state in the United States. Based on the 4-H Professional Research, Knowledge, and Competency (PRKC) Model (Stone & Rennekamp, 2004), youth development professionals rated their cultural competence (equity, access, and opportunity) in eight core competency areas. Based on a five-point Likert scale ranging from 0 = No knowledge to 4 = Expert, youth development professionals evaluated their cultural competence ranging from 0.66 to 4.00. According to an interpretive scale, most youth development professionals rated their competence as intermediate. Participants reported the skills of active listening and an open attitude as areas in which they felt most competent. Areas of least competence were community outreach policies and procedures. No significant relationships existed between the demographic variables of gender, degree earned, and field of study when compared to perceived cultural competence. The findings will be used to detect deficiencies and create opportunities for professional training and development experiences in supporting the cultural competence and growth of youth professionals.

DEVELOPMENTOF ANALYTIC RUBRICS FOR COMPETENCY ASSESSMENT

This project aims to create and validate generic rubrics that can be used to authentically assess learning outcomes in core competency areas. As these rubrics are intended for ongoing use by students and educators who have had no involvement in their development, ensuring consistent interpretation and application is a challenge. This paper describes the rubric development methodology and progress to-date on Teamwork, Communication, and Design rubrics including the refinement of outcomes, indicators, and descriptors in response to expert feedback. We also discuss challenges that have delayed testing and deployment as well as future steps.

Towards the Development of Educational Core Competencies for Couple and Family Therapy Technology Practices

Rises in technology have created change in the family therapy field. The ethics code and regulatory boards now include areas on technology in family therapy practices. These additions require competency in the area of couple and family therapy technology practices. Previous researchers suggest there is a gap between these competencies needed and the training provided, as well as the research available. Thus, the purpose of this mixed-data survey study was to gain information regarding family therapists’ experiences and perceptions of education regarding online family therapy practices. To do this, we administered a survey to family therapists across the United States. Reported, are both quantitative, as well as qualitative findings. The majority of the sample reported that they did not learn about online technologies in clinical practice; however the majority of the participants would like to learn more about couple and family therapy technology practices. The most direct implication of the findings from our study is the need to offer specific education around couple and family therapy technology practices. Suggested core competency areas to cover include theory, research, and practice around technology.

Developing a Multidisciplinary Simulation Course to Address the Physical Health Agenda in Mental Health: Recognising and Assessing Medical Problems in Psychiatric Settings (RAMPPS)

Introduction There’s a renewed focus on physical health for people with mental health conditions. In Yorkshire & Humber, a team were tasked with improving patient safety, outcomes and experiences through training and simulation. Objectives Recognising and Assessing Medical Problems in Psychiatric Settings (RAMPPS) provides opportunities to assess and manage deteriorations in physical health in a safe environment, where learner needs are paramount. It reflects the way situations unfold in real life with Health Care Assistants, Nurses and Psychiatric Trainees working together. Aims RAMPPS aims to improve effective communication, clinical, safety and collaborative skills. Scenarios test technical competencies around measurement and interpretation of observations, communication, handover of information and team dynamics. Methods Scenarios are based upon real-life incidents from psychiatric inpatient wards. Using high-fidelity manikins, part-task trainers, remote simulation technology and standardised patient-actors, we produced simulations akin to real-life. The RAMPPS course can be run in various ways: • Large simulation centres with scenarios running concurrently • Smaller simulation centres with live video • In-situ with equipment taken to a ward Confidence in competencies forms the core of paired pre- and post-course questionnaires; delegates act as their own control. Results Chi-square analysis of results shows a significant increase in confidence for doctors, nurses and health care assistants in core competency areas including communication, collaboration, clinical skills and organisational aspects of care. Conclusions RAMPPS is an effective and new way to incorporate effective simulation training in psychiatry. It can be adapted to the arrangement of the localities whilst retaining its core principles.

Blended e-learning and end of life care in nursing homes: a small-scale mixed-methods case study.

BackgroundA ‘blended’ (e-learning and facilitated workshops) training course for Group C staff (i.e. staff with relatively infrequent contact with end of life care) has been delivered across several English counties with the aim of improving end of life care in nursing and residential care homes. This paper evaluates the impact of the course on participants’ understandings of and confidence in delivering end of life care in one nursing home, while also considering barriers to change in practice.MethodsA mixed-methods case study approach, incorporating pre- and post-course questionnaires (SHA East of England End of Life Care Education Programme ‘ABC’ Project Work Force C or Non Nurse Workforce B Pre and Post Course Questionnaire; E-Learning in End of Life Care Study Pre and Post Course Questionnaire), documentary analysis, semi-structured interviews, and observation of course workshops. Participants were 20 members of staff at a nursing home in a city in the East of England, including 14 Health Care Assistants (carers) and 6 others (administrative, activities, hosting, and catering staff). The questionnaires and interviews assessed understandings of and confidence towards end of life care delivery.ResultsImprovements in participants’ confidence in delivering end of life care were observed, particularly in the core competency areas of symptom management, communication, and advance care planning. A shift towards more detailed and more holistic understandings of end of life care was in evidence; some participants also championed end of life care in the home as a result of the course. Several barriers to changes in practice were encountered, including uneven participation, the absence of mechanisms for disseminating new insights and knowledge within the home, and a widespread perception that nurses’ professional dominance in the home made sustainable change difficult to enact.ConclusionsWhile blended e-learning courses have the potential to generate positive change in participants’ understandings of and confidence about End of Life Care, organizational and inter-professional obstacles must be overcome in order to translate these changes into improved end of life care delivery in nursing (and residential) homes.

Consensus development on the essential competencies for Iranian public health nutritionists.

To assess key experts' opinion regarding essential competencies required for effective public health nutrition practice within the health-care system of Iran. Qualitative study using the modified Delphi technique through an email-delivered questionnaire. Iran. Fifty-five experts were contacted through email. The inclusion criterion for the study panel was being in a relevant senior-level position in nutrition science or public health nutrition in Iran. In the first round, forty-two out of fifty-five experts responded to the questionnaire (response rate=76 %). A sixty-five-item questionnaire was designed with nine competency areas, including 'nutrition science', 'planning and implementing nutritional interventions', 'health and nutrition services', 'advocacy and communication', 'assessment and analysis', 'evaluation', 'cultural, social and political aspects', 'using technology' and 'leadership and management'. All experts who had participated in the first round completed a modified version of the questionnaire with seventy-seven items in the second round. The experts scored 'nutrition science' as the most essential competency area, while more applied areas such as 'management and leadership' were less emphasized. In both rounds, the mean difference between the opinions of the necessity of each area was 5.6 %. The Iranian experts had general agreement on most of the core competency areas of public health nutritionists. The results indicated the need for capacity building and revisions to educational curricula for public health nutritionist programmes, with more emphasis on skill-based competency development.

American College of Occupational and Environmental Medicine's Occupational and Environmental Medicine Competencies-2014: ACOEM OEM Competencies Task Force*.

The preventive medicine foundation of occupational medicine impacts all the different practice areas of OEM, whether it involves preventing illness related to a hazardous exposure, treating injury due to an employee health condition, or addressing unnecessary work disability after an occupational injury. The OEM physicians are required to effectivelyinteractwithawiderangeofother professionals and provide guidance not only to patients but also to other clinicians and occupational health nurses, employers, safety and industrial hygiene professionals, human resource managers, attorneys, labor unions, and public health care professionals. In these interactions,OEMphysiciansshouldfollowa strict code of ethics related to matters of confidentiality and potential conflicts of interest. Detailed guidance in this area is provided in ACOEM Code of Ethics. 16 Effective communication in OEM includes risk communication, patient education, workforce education, development of policy and guidance documents, and medical/legal document preparation. Physicians practicing OEM typically

TOPSIS-AHP Based Approach for Selection of Reverse Logistics Service Provider: A Case Study of Mobile Phone Industry

Reverse supply chain logistics, means mobility of goods from end consumers towards core manufacturer in the channel of product distribution. In the turbulent business environment, the companies must promote alternative uses of resources that may be cost-effective and ecology friendly by extending products’ routine life cycles. Reveres logistics activities i.e. storing, transporting and handling of used products poses a great challenge to reverse logistics managers as there is always chances of uncertainty in terms of quantity, quality and timing of return of EOL products in case of reverse supply chains. Business organizations including those of white/electronics goods manufacturing industries would like to focus on their core competency areas and there is need of making outsourcing decisions of their reverse logistics process to Third-Party reverse Logistics Providers (3PRLPs). Thus, most important strategic issue for top management is the evaluation and selection of third party logistics service provider who can effectively provide reverse logistics operation services to the firms. The objective of this work is to develop decision support system to assist the top management of the company in selection and evaluation of different 3PRL service providers by hybrid approach using Analytical Hierarchy Process (AHP) and Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) method. A real life case study of a mobile phone manufacturing company is presented to demonstrate the steps of the decision support system. Present study also enables the logistics managers to better understand the complex relationships of the key attributes in the decision making environment and subsequently improve the reliability of the decision making process.

4-H Youth Development Professionals’ Perceptions of Youth Development Core Competence

The purpose of this descriptive study was to assess the perceived level of competence among 4-H Youth Development Agents from a Southern state in the United States. The findings will be used to identify gaps in and opportunities for professional training and development experiences in supporting the competence and growth of youth professionals. Based on the 4-H Professional Research, Knowledge, and Competency Model (Stone & Rennekamp, 2004), youth development professionals rated their youth development competence in nine youth development core competency areas. Utilizing a five-point Likert-type scale ranging from 1=no knowledge to 5=expert, youth development professionals rated their youth development competence ranging from 3.12 to 3.54. According to an interpretive scale, youth development professionals rated their competence as intermediate. Staff felt most competent in the areas of current youth issues, career opportunities for youth, and family structures/relationships. Staff felt least competent in the area of mental development of youth. No one identified themselves as an expert in the areas of psychological development, emotional development, and current youth issues.

Assessing competencies during education in psychiatry

The utilization of competencies in medical education is relatively recent. In 1999 the United States Accreditation Council for Graduate Medical Education (ACGME) established six main competencies. Since then, the American Board of Psychiatry and Neurology have approved a specific list of competencies for their specialities in each of the ACGME's core competency areas. Assessment of competencies in both medical students and residents can be achieved through such methods as structured case discussion, direct observation, simulation, standardized patients, and 360-degree assessments, etc. Each assessment methodology has specific applications in the discipline of psychiatry. This paper reviews the different methods for assessing competencies with specific examples in psychiatric education. It is not intended as a comprehensive review of all assessment methods, but to provide examples and strategies to guide psychiatric educators in their practice. Students and residents were intentionally separated because there are differences in the teaching goals and objectives, and thus in the assessment purposes and design. Students are general, undifferentiated physicians-in-training who need to learn about psychiatric nosology, examinations, and treatment. Residents are mental health professionals who need more in-depth supervision in order to hone skills in all the specialized areas that arise in psychiatric practices, making supervision a vital part of residency programs.

Impact of Participation on a Solid Organ Transplant Team on Student Pharmacists’ Perceptions of Interprofessional Roles

To examine student pharmacists' perceptions of interprofessional roles before and after completing an advanced pharmacy practice experience on solid organ transplantation. Student pharmacists across the United States participating in an APPE on a solid organ transplant team completed an online pre- and post-APPE survey instrument examining perceptions of interprofessional roles, communication, and teamwork. Student pharmacists' scores on interprofessionalism increased significantly on 17 of 22 items. Positive changes were seen in the interprofessional education core competency areas of roles and responsibilities, interprofessional communication, and teams and teamwork. Student pharmacist participation in interprofessional clinical APPEs can positively influence their professional development as they prepare to become members of multi-disciplinary teams in the healthcare workforce.

Selection of third-party reverse logistics providers for End-of-Life computers using TOPSIS-AHP based approach

Business organisations including those of computer companies would like to focus on their core competency areas and are, therefore, outsourcing all or part of their reverse logistics process to Third-Party Logistics Providers (3PLPs). Thus, a key strategic issue for top management is the selection of 3PLPs who can effectively provide reverse logistics services to organisation. This study aims to efficiently assist the decision-makers in determining the most appropriate third-party reverse logistics provider using a combination of Analytical Hierarchy Process (AHP) and Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) methods. A numerical example from a case company is included to demonstrate the steps of the proposed model.

Current medical students' understanding of Surgical Education and Training

The current Surgical Education and Training (SET) programme in Australia and New Zealand has been implemented to streamline surgical training. As applications to the SET programme can occur as early as the 2nd post-graduate year, early preparation is vital to ensure a successful outcome in gaining a SET position. We wish to demonstrate to what degree medical students are aware of the SET structure and application requirements to determine if further assistance to future SET candidates is required. A standardized questionnaire was delivered to students of an Australian Medical School via an online medium. Ethics approval was granted, and all surveys were completed anonymously and voluntarily. One hundred eighty-two completed surveys were received. Eighteen percent of surveyed participants felt they had a good understanding of the SET programme, with 82% stating they had minimal or no understanding of the programme. Fourteen percent felt they had the information needed to pursue a career in surgery. Fifty-three percent were unaware that the College outlined areas of core competencies required in their training, with 75% unable to name any core competencies. There are a large proportion of medical students potentially considering a career in surgery. However, only a small number feel that they have been adequately equipped throughout their medical course to understand the steps needed to build a strong application for SET.

Core Competencies for Cardiac Rehabilitation/Secondary Prevention Professionals

Cardiac rehabilitation/secondary prevention (CR/SP) services are typically delivered by a multidisciplinary team of health care professionals. The American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) recognizes that to provide high-quality services, it is important for these health care professionals to possess certain core competencies. This update to the previous statement identifies 10 areas of core competencies for CR/SP health care professionals and identifies specific knowledge and skills for each core competency. These core competency areas are consistent with the current list of core components for CR/SP programs published by the AACVPR and the American Heart Association and include comprehensive cardiovascular patient assessment; management of blood pressure, lipids, diabetes, tobacco cessation, weight, and psychological issues; exercise training; and counseling for psychosocial, nutritional, and physical activity issues.

Use of Simulation Technology in Forensic Medical Education

Although the emergency department often provides the first and only opportunity to collect forensic evidence, very few emergency medicine residencies have a forensic medicine curriculum in place. Most of the existing curricula are composed only of traditional didactics. However, as with any lecture‐based education, there may be a significant delay between the didactic session and clinical application. In addition, traditional curricula lack the opportunity for residents to practice skills including evidence collection, documentation, and use of a colposcope. At York Hospital, we have developed a forensic curriculum which consists of both traditional lectures and practical experience in our Medical Simulation Center. As part of their educational conference series, residents receive presentations on domestic violence, child abuse, elder abuse, evidence collection, sexual assault, ballistics, pattern injuries, documentation, forensic photography, and court testimony. Following these presentations, residents have the opportunity to apply their knowledge of forensic medicine in the Simulation Center. First, they interview a standardized patient. They then utilize the mannequins in the Simulation Center to practice evidence collection, photo documentation, and use of our specialized forensic medicine charts. After evidence collection and documentation, the residents provide safety planning for the standardized patients. Each portion is videotaped, and each resident is debriefed by victim advocates, experienced sexual assault nurse examiners, and emergency department faculty. The use of simulation technology in resident education provides the opportunity to practice the skills of forensic medicine, ultimately benefiting patients, residents, and law enforcement, and permitting teaching and evaluation in all six core competency areas.

Development of Core Competencies for Paraprofessional Nutrition Educators Who Deliver Food Stamp Nutrition Education

The purpose of this project was to describe the process used for the development of core competencies for paraprofessional nutrition educators in Food Stamp Nutrition Education (FSNE). The development process included the efforts of an expert panel of state and multicounty FSNE leaders to draft the core competencies and the validation of those competencies by FSNE paraprofessionals. The result of the project was a comprehensive list of 10 core competency areas with specific competencies for each. The core competencies will be useful with FSNE for state and local program planning, implementation, evaluation, and decision making, with possible implications for other community-based education programs.