Variable trajectory: a systematic review, analytic synthesis and construct domain consolidation of international measures of competence in doctors and medical students.
education & training (see medical education & training)
human resource management
medical education & training
medical ethics
quality in health care
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
23 08 2021
23 08 2021
Historique:
entrez:
24
8
2021
pubmed:
25
8
2021
medline:
28
8
2021
Statut:
epublish
Résumé
Competence is assessed throughout a doctor's career. Failure to identify and manage impaired competence can have critical consequences. Consistent conceptualisation and accurate measurement of this construct is imperative. Therefore, the objective of this review was to identify and evaluate measures used to assess competence in doctors and medical students. A systematic search of the published literature was undertaken between December 2019 and February 2020 for articles reporting on the measurement of competence in doctors and/or medical students. Searches were conducted in the PsychSOURCE, US National Library of Medicine National Institutes of Health, MEDLINE (PubMed), The Cochrane Central Register of Controlled Trials and Web of Science electronic databases. Citation screening and forward citation tracking of included studies were carried out to identify any further relevant papers for inclusion. One thousand one hundred and thirty-six potentially relevant articles were screened. An analytic synthesis approach was implemented to the identification, organisation and interpretation of homogenous study and measure characteristics. Twelve competence domains were identified from the 153 identified measures. Knowledge and procedural competence domains were the dominant focus of publications reporting current medical practice, but less so in research-based studies which more frequently assessed interpersonal, psychological, physiological and ethical competencies. In the 105 included articles, the reporting of measurement instrument quality was varied, with comprehensive reporting only present in 53.6% of measures; validation for some of the measures was particularly limited. While this review included a considerable number of publications reporting the measurement of competence in doctors and medical students, the heterogeneity of the measures and variation of findings limit the ability to evaluate their validity and generalisability. However, this review presents a resource for researchers and medical educators which may inform operational practice and future research. CRD42020162156.
Sections du résumé
BACKGROUND
Competence is assessed throughout a doctor's career. Failure to identify and manage impaired competence can have critical consequences. Consistent conceptualisation and accurate measurement of this construct is imperative. Therefore, the objective of this review was to identify and evaluate measures used to assess competence in doctors and medical students.
METHODS
A systematic search of the published literature was undertaken between December 2019 and February 2020 for articles reporting on the measurement of competence in doctors and/or medical students. Searches were conducted in the PsychSOURCE, US National Library of Medicine National Institutes of Health, MEDLINE (PubMed), The Cochrane Central Register of Controlled Trials and Web of Science electronic databases. Citation screening and forward citation tracking of included studies were carried out to identify any further relevant papers for inclusion. One thousand one hundred and thirty-six potentially relevant articles were screened. An analytic synthesis approach was implemented to the identification, organisation and interpretation of homogenous study and measure characteristics.
RESULTS
Twelve competence domains were identified from the 153 identified measures. Knowledge and procedural competence domains were the dominant focus of publications reporting current medical practice, but less so in research-based studies which more frequently assessed interpersonal, psychological, physiological and ethical competencies. In the 105 included articles, the reporting of measurement instrument quality was varied, with comprehensive reporting only present in 53.6% of measures; validation for some of the measures was particularly limited.
DISCUSSION
While this review included a considerable number of publications reporting the measurement of competence in doctors and medical students, the heterogeneity of the measures and variation of findings limit the ability to evaluate their validity and generalisability. However, this review presents a resource for researchers and medical educators which may inform operational practice and future research.
PROSPERO REGISTRATION NUMBER
CRD42020162156.
Identifiants
pubmed: 34426462
pii: bmjopen-2020-047395
doi: 10.1136/bmjopen-2020-047395
pmc: PMC8383887
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e047395Informations de copyright
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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