Competency framework development in healthcare : a physiotherapy perspective

Date
2023-03
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Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH SUMMARY: Background: Across the globe, countries are challenged to design healthcare systems that succeed in delivering equitable healthcare to their citizens. A competent health workforce has been cited as essential to address the burden of disease and improve the health of individuals and communities. Competency frameworks are important tools to describe such a workforce, reporting the skills, knowledge, behaviours and attitudes needed to meet the population’s health needs. However, for the profession of physiotherapy, consensus on competencies is not clearly defined. This poses a challenge to the development of physiotherapy competency frameworks. Understanding the global perspectives on physiotherapy competencies may assist in the development of competency frameworks that are applicable to the local context. Aims: The aims of this thesis are to identify and synthesise published physiotherapy competencies, and present a conceptual thematic framework which may guide the future development of contextually relevant physiotherapy competency frameworks. Methodology: Two separate phases were undertaken to accomplish the research aims. In phase 1, a document review of all published physiotherapy competencies was conducted. All competencies from these documents were extracted and collated within the structures of the Canadian Medical Education Directions for Specialists (CanMEDS) and the World Health Organization Rehabilitation Competency Framework (WHO RCF). Phase 2 utilised an inductive approach to thematically analyse the competency statements from the WHO RCF dataset compiled in phase 1. Results: The document review identified 20 documents for inclusion, with the first published in 2008 (Ireland) and the latest in 2021 (Latvia). The majority of current physiotherapy competency documents, and thus the descriptions of physiotherapy competencies, originate from high-income countries. The competencies extracted from all included documents could be accommodated within both the WHO RCF and the CanMEDS framework, suggesting that either may be used for developing competency frameworks for the physiotherapy profession. From the WHO RCF dataset, a conceptual thematic framework was developed consisting of 17 themes and 59 sub-themes. Conclusion: With the changing profile of the burden of disease, healthcare systems and the role of the physiotherapist must evolve. Adequately describing the competencies for physiotherapists to excel in their work is foundational to the credibility of the profession not only among health professions but within society. This thesis provides an updated perspective on physiotherapy competencies and serves as a springboard from which to define contextually relevant physiotherapy competencies. This conceptual thematic framework can aid in the development of a physiotherapy competency framework in any setting.
AFRIKAANSE OPSOMMING: Agtergrond: Wereldwyd ervaar lande dit uitdagend om gesondheidsisteme te skep wat billike gesondheidsorg aan hul burgers kan verskaf. ‘n Bevoegde gesondheidsarbeidsmag word gesien as noodsaaklik om die druk van siektes aan te spreek en die gesondheid van individue en gemeenskappe te bevorder. Vaardigheidsraamwerke word as belangrike instrumente beskou om ‘n arbeidsmag te beskryf met betrekking tot die bevoegthede, kennis, gedrag en houdings wat benodig word om die bevolking se gesondheidsbehoeftes aan te spreek. Vir die fisioterapieberoep is sodanige vaardighede nog nie gedefinieer nie. Hierdie situasie hou ‘n uitdaging in vir die ontwikkeling van die beroep se vaardigheidsraamwerke. ‘n Begrip van wereldperspektiewe aangaande fisioterapievaardighede kan die ontwikkeling van relevante vaardigheidsraamwerke bevorder. Doelstellings: Die doelstellings van hierdie tesis was om gepubliseerde fisioterapievaardighede te identifiseer en te analiseer, asook om ‘n rigtingsgewende raamwerk daar te stel wat die ontwikkeling van vaardigheidsraamwerke vir hierdie beroep kan ondersteun. Metodiek: Twee afsonderlike fases is uitgevoer om die navorsingsdoelstellings te bereik. In fase 1 is ‘n dokumentondersoek geloods om bestaande fisioterapie-vaardighede te identifiseer. Hierdie ondersoek het alle vaardighede uit die geselekteerde raamwerke onttrek, en dit noukeurig gesorteer binne die strukture van die Canadian Medical Education Directions for Specialists (CanMEDS) en die World Health Organization Rehabilitation Competency Framework (WHO RCF). ‘n Tematiese analise van die WHO RCF datareeks is in fase 2 gedoen. Tydens hierdie fase is ‘n induktiewe benadering gevolg om elke vaardigheidstelling te analiseer. Resultate: Die dokumentondersoek het 20 dokumente ingesluit, waarvan die eerste in 2008 (Ierland) en die mees onlangse in 2021 (Latvie) gepubliseer is. Die meeste onderliggende fisioterapie-vaardighede vloei voort vanuit lande met bogemiddelde raamwerk en die WHO RCF albei van waarde kan wees vir gebruik in die ontwikkeling van ‘n fisioterapie vaardigheidsraamwerk, aangesien alle onttrekte vaardighede binne die twee raamwerke geakkommodeer kon word. Die tematiese analise het gelei tot ‘n rigtingsgewende raamwerk wat ‘n totaal van 17 temas en 56 subtemas oor die vyf domeine van die WHO RCF verteenwoordig. Gevolgtrekking: Die veranderende las van siektes eis dat gesondheidsorgsisteme en die rol van die fisioterapeut voortdurend uitbrei and verbreed. Die geloofwaardigheid van die professie sal verseker word as fisioterapeute optimaal binne die nodige vaardighede vir fisioterapeute kan funksioneer. Hierdie tesis verskaf ‘n beginpunt waarvan hierdie vaardighede kontekstueel gedefineer kan word. Dit verskaf verder ‘n ingeligte perspektief op fisioterapievaardighede. Toekomstige navorsing sal hierdie resultate kan toepas in die ontwikkeling van fisioterapie-vaardigheidsraamwerke.
Description
Thesis (MScPhysio)--Stellenbosch University, 2023.
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