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Using job analysis to identify core and specific ...

Using job analysis to identify core and specificcompetencies: implications for selection andrecruitmentFiona Patterson,1 Eamonn Ferguson2& Sarah Thomas3 OBJECTIVEM odern postgraduate medical trainingrequires both accurate and reliable selection proce-dures. An essential first step is to conduct detailed jobanalysis studies. This paper reports data on a seriesof job analyses to develop a competency model forthree secondary care specialties (anaesthesia,obstetrics and gynaecology, and paediatrics).METHODST hree independent job analysis studieswere conducted. The content validity of the result-ing competency domains was tested Using a ques-tionnaire- based study with specialty trainees(specialist registrars [SpRs]) and consultants drawnfrom the three specialties.

competencies: implications for selection and recruitment ... analysis studies. This paper reports data on a series of job analyses to develop a competency model for three secondary care specialties (anaesthesia, obstetrics and gynaecology, and paediatrics). ... The model reported is based on the application of job analysis techniques to medical ...

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1 Using job analysis to identify core and specificcompetencies: implications for selection andrecruitmentFiona Patterson,1 Eamonn Ferguson2& Sarah Thomas3 OBJECTIVEM odern postgraduate medical trainingrequires both accurate and reliable selection proce-dures. An essential first step is to conduct detailed jobanalysis studies. This paper reports data on a seriesof job analyses to develop a competency model forthree secondary care specialties (anaesthesia,obstetrics and gynaecology, and paediatrics).METHODST hree independent job analysis studieswere conducted. The content validity of the result-ing competency domains was tested Using a ques-tionnaire- based study with specialty trainees(specialist registrars [SpRs]) and consultants drawnfrom the three specialties.

2 Job analysis was carriedout in the Yorkshire and the Humber region in theUK. The validation study was administered withadditional participants from the West Midlandsand Trent regions in the UK. This was anexploratory study. The outcome is a set of compe-tency domains with data on their importance atsenior house officer, SpR and consultant grade ineach study produced a model comprising 14general competency domains that were common toall the three specialties. However, there were signifi-cant between-specialty differences in both definitionsof domains and the ratings of importance attachedto results indicate that a wide rangeof attributes beyond clinical knowledge and academicachievement need to be considered in order toensure doctors train and work within a specialty forwhich they have a particular aptitude.

3 This hassignificant implications for developing selectioncriteria for specialty training. Future research shouldexplore the content validity of these competencydomains in other secondary care *education, medical, graduate; anaesthesiology *education standards; obstetrics *education standards; paediat-rics *education standards; *school admission criteria; clinicalcompetence *standards; multicentre study [publication type]; Education 2008:42: 1195 1204 a result of the Modernising Medical Careers(MMC) initiative in the UK, fundamental changes inpostgraduate medical training have placed moreemphasis on selecting doctors into specialty ,2 selection criteria for all specialties were stan-dardised in the UK for 2007, and were described inthe specialty- specific Person and fiercely debated initiative must beinformed by an empirically driven evidence base.

4 Thispaper reports on an analysis used to facilitate thedevelopment of selection systems for entry intospecialty training. The model reported is based onthe application of job analysis techniques to medicalselection. We present these data to encourage furtherdebate within the wider medical and scientificcommunity, with the aim of developing an agenda forfuture achieve a robust selection system, the most crucialstep is to identify both the core skills ( competencies )selection1 Department of Psychology, City University, London, UK2 School of Psychology, University of Nottingham, Nottingham,UK3 Yorkshire and the Humber Postgraduate Deanery, University ofSheffield, Sheffield, UKCorrespondence: Professor Fiona Patterson, OrganisationalPsychology, City University, Northampton Square, London EC1V0HB, UK.

5 Tel: 00 44 115 940 7978; Fax: 00 44 115 940 7978;E-mail: Blackwell Publishing Ltd 2008. MEDICAL EDUCATION 2008;42: 1195 12041195common to all specialties and the competencies thatdiscriminate between ,4 Job analysistechniques form the basis of developing any selectionsystem. Classifying the combination of core andspecific competencies ensures that both generic andspecialty- specific skills are recognised. This identifi-cation process informs the development of selectioncriteria (in addition to aiding careers counselling fortrainees) and is the basis of a reliable, valid andlegally defensible selection paperreports data identifying core and specific competen-cies for three different secondary care specialties:anaesthesia; obstetrics and gynaecology, andpaediatrics.

6 The methodology can be adopted forother key questions are addressed in this paper:1 What are the competency domains observedacross various specialties?2 How important is each domain for the seniorhouse officer (SHO), specialist registrar (SpR)and consultant grades?3 Are certain competency domains perceivedas more importantwithina particularspecialty?4 Are there differencesbetweenthe specialties inthe importance given to each competencydomain?METHODSD esign and procedureThe job analyses were conducted within a two-phaseprogramme of research. Phase 1 was qualitative andbased on a previously described reliable and validprocedure for job analysis in fromPhase 1 were applied to develop a questionnaire thatwas used to conduct the second phase of the jobanalyses, in Phase the aim was to explore core and specialty-specificcompetencies in secondary care, three specialtieswere examined: anaesthesia; obstetrics and gynae-cology, and paediatrics.

7 These were chosen becausethey are all hospital- based and each specialty differsfrom the others in terms of the nature of interactionswith patient groups and the amount of time com-mitted to ongoing patient care. For example, bothobstetrics and gynaecology and anaesthesia are craftspecialties, whereas paediatrics may be classed as amedical specialty. In anaesthesia, a relatively lowerproportion of patient contact time is spent inoutpatient 1. Qualitative job analysisA multi-source, multi-method job analysis wascarried out Using a similar methodology to thatused in our previous work to identify competencydomains for general ,6,7 Four jobanalysis methods were conducted in each specialtyincluding:1observation, by a trained occupational psycholo-gist, of the practice of consultants and SpRs ineach specialty (n= 26) over a total of days;2critical incidents focus groupswith doctors (fivegroups with a total of 13 consultants and 26 SpRs), and focus groups with other health careprofessionals relevant to each specialty, includingnurses, midwives, operating assistants (six groupswith a total of 25 professionals).

8 3critical incidents interviews with doctors(n= 14)andwith patients(n= 91), andOverviewWhat is already known on this subjectRecent changes in postgraduate training placemore emphasis on selection practices. Morefocused information is needed to guide careerchoices for specialty this study addsBehavioural competencies that underpin effec-tive performance in three secondary care spe-cialties have been identified and validated. Thisresearch is unique in combining the perspectivesof qualified doctors, trainees, health care pro-fessionals and patients. Important differences inpriorities between specialties, contributingto effective performance in training, for further researchJob analysis methodology might be applied inother specialties to identify selection information gathered in postgraduatetraining might be used to more closely informundergraduate selection Blackwell Publishing Ltd 2008.

9 MEDICAL EDUCATION 2008;42: 1195 1204F Pattersonet alTable 1 Sampling and methods for Phase 1 researchMethod*DesignAnaesthesiaObstetri cs andgynaecologyPaediatricsObservationof practiceBehavioural observationof randomly selecteddoctor patient anddoctor supportstaff interactions; days per for each specialtyincluded males and had minimum5 10 years experience;SpRs had 2 4 yearsexperienceConsultantsn=3n=4n=4 SpRsn=4n=6n=5 Focus groupsCritical incidents techniquefocus groups; allparticipants hadminimum of 2 years experienceDoctorsNot available becauseof practical , one-to-oneinterviews conducted (see below)2 groups: consultants(n= 5; 4 male, 1 female, years) and SpRs (n=9;7 female, 2 male, years)3 groups: consultants(n= 8) and 2 groupsof SpRs (n= 17)Other healthcareprofessionals3 groups: ITU pain clinicnurses (n= 4; female, 14 years);operating departmentassistants (n= 2; male, 10 years);clinical and anaesthetic servicesmanagers (n= 3; female, 17 years)2 groups: nurses (n=6;female, 8 years) andmidwives (n=6;female, 18 years)1 group: paediatricnurses (n= 4; 16 years)InterviewsCritical incidents techniqueinterviews; sample ofpatients attendingoutpatients clinicDoctorsConsultants (n= 9; 8 male, 1female, 8 years) SpRs (n=2;male, 2 years) Surgeons (n=3;male, 9 years)Patientsn= 25 (mean age 49 years, range22 73 years; response rate 86%.)

10 English not first language = 1)n= 34 (mean age 44 years,range 19 78 years; responserate 76%; English not firstlanguage = 2)n= 32 (mean age ofchild 8 years; responserate 87%; parents carers: 31 female(mean age 33 years),16 male (mean age36 years); English notfirst language = 4* Convenience samples were used throughoutSpR = specialist registrar Blackwell Publishing Ltd 2008. MEDICAL EDUCATION 2008;42: 1195 12041197 Using job analysis to identify core and specific competencies4reviews ofresearch literature( MEDLINE searches) andspecialty training materials(RoyalCollege curriculum documents).The purpose of these analyses was to identifycompetency domains relevant to each specialty inaddition to those common across all three.


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