The development of a South African medical practitioners competency questionnaire

Fourie, Menanteau (2016-03)

Thesis (MCom)--Stellenbosch University, 2016

Thesis

Medical practitioners are without a doubt one of the most fundamental role players in the functioning of hospitals and community health. The fraternity of industrial psychology can contribute to interventions ensuring optimal medical practitioner performance. The long-term objective of the study is to develop and test a medical practitioner competency model which is a structural model that reflects the medical practitioner competency potential variables, the situational variables as well as the competencies (behaviours) and outcomes that constitute medical practitioner performance. However, this objective was deemed slightly too ambitious for a single research study and consequently only the first phase of this research was done. This research aims to determine what behaviours constitute medical practitioner performance success. The research objectives were twofold. Firstly, to constitutively define the medical practitioner performance construct by developing a partial competency model and secondly, to develop a South African behavioural performance measure that could eventually be used to obtain multi-rater assessments of the latent behavioural variables in the partial South African Medical Practitioner’s Competency Model. From the literature study a partial medical practitioner competency model was developed that explicates the different latent behavioural and outcome variables comprising job performance of medical practitioners and the manner in which these latent variables are structurally interrelated. The South African research on this topic is extremely limited and therefore research had to be done to determine the competencies relevant to the South African context. A qualitative research approach was adopted to discover what behaviours are required for effective medical practitioner performance. In depth interviews were conducted utilising both the Repertory Grid and the Critical Incident Technique. This combination of techniques was highly effective in that the research question was investigated from different positions. The repertory grid phase of the interview allowed participants to contrast different behaviours in relation to medical practitioner performance which mainly lead to the identification of themes that was not identified in the literature review. During the critical incident phase of the interview the participants described specific behaviours in translating the meaning of the identified competencies in the South African context. Due to the exploratory nature of this research study an interpretivism research paradigm was adopted. A sample of seven family physician (specialised medical practitioners) was used in the data gathering phase. All participants are also employed in a supervisory role at respective public hospitals in South Africa. Through thematic analysis thirty-two distinct first-order themes relating to medical practitioner performance was elicited. These themes were contrasted with the competencies identified from literature and it were established that 31% of the themes were additional to the identified competencies from the literature study. The researcher categorised the first-order themes into eleven second-order themes. The behavioural denotations presented by the participants were used to write items for the South African Medical Practitioner Competency Questionnaire (SAMPCQ). The questionnaire still needs to be validated in future before it could be adopted in practice. The SAMPCQ could be used in future for performance evaluations and to determine developmental areas of medical practitioners. The South African Medical Practitioner Competency Model (SAMPCM) will eventually indicate the outcomes, competencies and competency potential required for effective medical practitioner performance. This contribution can assist with selection processes on tertiary level and development on a tertiary and post-tertiary level as the factors contributing to successful medical practitioner performance are understood.

Mediese praktisyns is sonder twyfel een van die mees fundamentele rolspelers in die effektiewe bedryf van hospitale en gemeenskap gesondheid. Die Bedryfsielkunde professie kan bydra tot prestasieverbetering-intervensies vir mediese praktisyns, deur die ontwikkeling van prestasie-meetinstrumente. Die langtermyn doel van hierdie studie is om 'n strukturele mediese praktisynbevoegdheidsmodel te ontwikkel en te toets, wat die bevoegdheidspotensiaal, die situasie veranderlikes asook die bevoegdhede (gedrag) en uitkomste wat mediese praktisyn prestasie uitmaak, weerspieël. Hierdie doelwit was as effens te ambisieus geag vir ‘n enkele navorsingstudie en gevolglik was slegs die eerste fase van die navorsing gedoen in die studie. Die navorsingstudie poog om te bepaal watter gedrag bydra tot die uiteindelike sukses van ‘n doeltreffende mediese praktisyn. Die navorsingsdoelwitte was tweeledig; eerstens, om konstitutief die mediese praktisyn prestasie-konstruk te definieer deur die 'n gedeeltelike bevoegdheidsmodel te ontwikkel, en tweedens, om 'n Suid-Afrikaanse gedragsprestasie-meetinstrument te ontwikkel wat uiteindelik gebruik kan word om 'n multi-assessering van die latente gedragsveranderlikes te verkry in die gedeeltelike Suid-Afrikaanse Mediese Praktisyn Bevoegdheidsmodel. 'n Gedeeltelike mediese praktisyn bevoegdheidsmodel is ontwikkel vanuit die literatuurstudie wat uit die verskillende latente gedrags- en uitkoms veranderlikes bestaan, wat werkprestasie van mediese praktisyns en die wyse waarop hierdie latente veranderlikes struktureel interafhanklik, uiteensit. Suid-Afrikaanse navorsing rakende hierdie onderwerp is uiters beperk en daarom word navorsing op mediese praktisynprestasie in die Suid Afrikaanse konteks benodig. Die doelstelling van hierdie studie is dus om tot ‘n dieper begrip van mediese praktisynprestasie te kom. In-diepte onderhoude was gevoer met behulp van beide die repertoirerooster tegniek (‘repertory grid technique’) en die kritieke insidenttegniek. Hierdie kombinasie van tegnieke was hoogs effektief aangesien die navorsingsvraag vanuit verskillende posisies ondersoek kon word. Die repertoirerooster het die deelnemers toegelaat om verskillende gedragsankers te identifiseer, wat betrekking het op mediese praktisynprestasie. Die geïdentifiseerde gedragsankers het uiteindelik bygedra tot die vasstelling van nuwe bevoegdhede wat nie geïdentifiseer was vanuit die literatuuroorsig nie. Tydens die kritieke insidentfase van die onderhoude het deelnemers spesifieke senarios beskryf waartydens voorbeelde van effektiewe en minder effektiewe gedrag, van die geïdentifiseerde bevoegdhede, aangedui was. As gevolg van die ondersoekende aard van hierdie navorsingstudie is 'n interpretivisme navorsingsparadigma aangeneem. 'n Steekproef van sewe huisartse (gespesialiseerde mediese praktisyns) is gebruik in die data- insamelingsfase. Alle deelnemers is tans ook aangestel in 'n toesighoudende rol by onderskeie publieke hospitale in Suid-Afrika. Deur tematiese ontleding is twee-en-dertig afsonderlike eerste-orde temas geïdentifiseer wat betrekking het tot mediese praktisynprestasie. Hierdie twee-en-dertig temas is vergelyk met die geïdentifiseerde bevoegdhede wat via die literatuuroorsig geïdentifiseer is en dit is vasgestel dat 31% van die temas bykomend was tot die bevoegdhede wat uit die literatuurstudie geïdentifiseer is. Die eerste-orde temas is in elf tweede-orde temas gekategoriseer. Die gedragsdenotasies, voorgestel deur die deelnemers, is gebruik om items vir die Suid-Afrikaanse Mediese Praktisyn Bevoegdheidsvraelys (SAMPCQ) te skryf. Die vraelys moet in die toekoms gevalideer word voordat dit in die praktyk gebruik mag word. Die SAMPCQ kan in die toekoms gebruik word vir prestasie evaluerings en vir die identifisering van ontwikkelings areas van mediese praktisyns. Die Suid-Afrikaanse Mediese Praktisyn Bevoegdheidsmodel (SAMPCM) sal uiteindelik die uitkomste, bevoegdhede en bevoegdheidspotensiaal vir doeltreffende geneesheerprestasie aandui. Indien die geïdentifiseerde faktore toegepas word tydens seleksie prosesse op tersiêre vlak, asook ontwikkeling op 'n tersiêre en post-tersiêre vlak, sal dit bydra tot suksesvolle geneesheerprestasie.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/98562
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