Abstract:

Background and aim(s):
Nowadays, workplace learning in healthcare education is often guided by competency-based educational methods. Various competence frameworks have been constructed but have not been interdisciplinary validated in undergraduate healthcare education. Therefore, we conducted a Delphi study 1) to validate the CanMEDS roles (7) and key competencies (27) in 8 different undergraduate healthcare educational programs, and 2) to provide recommendations for the validation of the CanMEDS competence framework.

Methods:
A three round online Delphi method with experts i.e. teachers, mentors, internship coordinators and educational experts from audiology, dental hygiene, midwifery, nursing (bachelor and associate degree), occupational therapy, podiatry and speech therapy, was used. Experts scored the relevance, clarity and measurability of each key competency (27). Consensus was defined as 70% or more of the experts scoring positively on a 6-point Likert scale. The level of consensus was calculated and quantitatively analyzed using SPSS26. Differences in scoring behavior between expert groups (e.g. healthcare profession, experience level etc.) were explored after each round using a one-way-ANOVA design. In round 1, experts could also give qualitative comments to clarify their score, adjust key competencies without consensus and form recommendations. In round 2, we presented the non-validated key competencies to the experts for further validation using the same scoring methods as used in round 1. Round three is still ongoing.

Results:
Round 1 and 2 respectively included 38 and 37 experts. After quantitative analysis of round 1, there was no consensus about the relevance of 2 key competencies, the clarity of 3 key competencies and the measurability of 19 key competencies. Qualitative remarks were used to clarify (21) or adjust (3) key competencies. After round 2, 3 of the 27 competencies were not validated. There was no significant difference in scoring behavior between expert groups.

The analysis further revealed that:
1) key competencies needed concrete enabling competencies to maximize measurability, that
2) not all key competencies could be assessed at any moment during the program,
3) some key competencies could never be assessed during the program which emphasizes the importance of continuous professional development (CPD).

Discussion and conclusions:
The CanMEDS competence framework might be used to support interprofessional education across 8 different undergraduate healthcare professions. Thereby, we can conclude that with this Delphi study, we can confirm the possibility of successfully validating a generalizable competence framework to support workplace learning processes.

Future research:
Future research is necessary to validate (newly) formulated enabling competencies to optimize measurability.

Keywords:

CanMEDS, undergraduate healthcare education, interdisciplinary, online Delphi.