4.6 Article

Development and Validation of the WHO Rehabilitation Competency Framework: A Mixed Methods Study

Journal

ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION
Volume 102, Issue 6, Pages 1113-1123

Publisher

W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.apmr.2020.10.129

Keywords

Clinical competence; Competency-based education; Education; Health workforce; Professional competence; Rehabilitation

Funding

  1. United States Agency for International Development

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By using mixed methods, this study identified the core values, beliefs, competencies, behaviors, activities, and tasks required by the rehabilitation workforce, showing a strong consensus on shared competencies and behaviors among rehabilitation professionals. The development of the Rehabilitation Competency Framework is crucial for building workforce capability, improving quality of care, and strengthening a common rehabilitation workforce identity.
Objectives: To identify the competencies, behaviors, activities, and tasks required by the rehabilitation workforce, and their core values and beliefs, and to validate these among rehabilitation professionals and service users. Design: Mixed methods study, involving a content analysis of rehabilitation-related competency frameworks, a modified Delphi study, and a consultation-based questionnaire of service users. Setting: Desk-based research. Participants: Participants who completed the first (N=77; 47%) and second (N= 68; 67%) iterations of the modified Delphi study. Thirty-seven individuals participated in the service user consultation. Collectively, the participants of the mixed methods study represented a significant range of rehabilitation professions from a broad range of countries, as well as both high- and low-income settings. Interventions: Not applicable. Main Outcome Measures: Not applicable. Results: The mixed methods study resulted in the inclusion of 4 core values, 4 core beliefs, 17 competencies, 56 behaviors, 20 activities, and 62 tasks in the Rehabilitation Competency Framework. The content analysis of rehabilitation-related competency frameworks produced an alpha list of competencies, behaviors, activities and tasks (statements), which were categorized into 5 domains. The final iteration of the modified Delphi study revealed an average of 95% agreement with the statements, whereas the service user consultation indicated an average of 87% agreement with the statements included in the questionnaire. Conclusions: Despite the diverse composition of the rehabilitation workforce, this mixed methods study demonstrated that a strong consensus on competencies and behaviors that are shared across professions, specializations, and settings, and for activities and tasks that collectively capture the scope of rehabilitation practice. The development of the Rehabilitation Competency Framework is a pivotal step toward the twin goals of building workforce capability to improve quality of care and strengthening a common rehabilitation workforce identity that will bolster its visibility and influence at a systems-level. (C) 2020 Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine.

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