Determining Professional Competence in 21st Century Healthcare

Professor Zubin Austin recently participated in a groundbreaking study of the triggers for disengagement in healthcare professionals. “Preventing small problems from becoming big problems in health and care,” a publication of the Health and Care Professionals’ Council (HCPC) in the United Kingdom, aims to address the role of healthcare providers in delivering safe and effective care to patients.

Founded in 2001, the HCPC is the regulatory body for many of the country’s health professions, and the largest organization of its kind in the world, tasked with protecting the health and wellbeing of people who use the services of its health and care professionals.

This publication explores engagement and disengagement, and how they impact our understanding of the competence of healthcare professionals. Professor Austin’s contribution makes up the first half of this research report, consisting of a literature review and illustrating how competence in healthcare has many meanings and competing frameworks (including those based on knowledge, performance, psychometrics, reflection, and outcome-based approaches). This section also demonstrates how new and emerging constructs about teamwork, emotional intelligence, and engagement may enable healthcare to shift approaches toward a model that is aligned with contemporary practices and values.

This project, related research, and resulting publication came about because of a series of events that transpired at the Mid Staffordshire Hospital several years ago. There, groups of individually competent healthcare professionals worked collectively as a team to provide horrible care to patients leading to multiple deaths. Since that time, regulators have struggled to account for the causes of this catastrophic systemic failure. As the regulatory body overseeing many of the health professionals involved in this tragedy, the HCPC sought to review what happened and determine appropriate solutions.

To aid in this mission, Professor Austin was invited to participate in the HCPC’s examination of and response to this disaster. He participated in several interviews and embarked on a comprehensive research project to determine competency and competency assessment within the healthcare field. Through his international reputation as an exceptional researcher in the field of maintenance-of-competency assessment, Professor Austin was called upon to lend his expertise to determining and understanding the potential causes and contributing factors that led to this event, which culminated in the publication of this report.

Professor Austin concludes his piece by noting the shortcomings of the checklist approach to defining knowledge and skills, and the insufficiencies of traditional constructs of competency that emphasize individuals’ technical or cognitive skill sets. He laments the non-existence of a single comprehensive competence discourse able to adequately capture the nuanced complexity of contemporary healthcare professionals’ work, but looks to the emerging notions of teamwork, emotional intelligence, and engagement as important concepts in defining and evaluating competency going forward.

Underlying this discussion is a clear message that engaged healthcare professionals result in better health outcomes and improved quality of care, which is reflected and expanded upon in the second half of this research report.

To read this report and learn more about Professor Austin’s observations about healthcare competency models, please click here.