Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada.
Princess Margaret Cancer Centre, Toronto, Canada.
Support Care Cancer. 2020 Feb;28(2):797-808. doi: 10.1007/s00520-019-04823-z. Epub 2019 May 31.
As the demand in cancer care continues to increase, health systems require a workforce of highly educated specialists and generalists to provide continuity of care across settings.
Led by de Souza Institute in Canada, an interdisciplinary working group was formed to develop a competency framework with relevance across regulated health professionals involved in cancer care.
The working group was presented with results from a scoping review of national and international guidelines, standards, and competencies in oncology, as well as data from needs assessments on continuing education opportunities and oncology topics most relevant to clinicians. Fifty-one professionals from, e.g., family medicine, pharmacy, social work, psychology, occupational therapy, and nursing participated in seven focus groups. An additional 32 nurses participated in a nursing-specific needs assessment survey. Using modified Delphi technique, working group members conducted three iterative rounds to review data and built consensus on competency items in relation to three levels of expertise, from early learner/novice practitioner, advancing practitioner, to expert practitioner.
A final consensus was reached for the selection of competencies that reflect optimal cancer care mapped into three levels of expertise, as well as knowledge, skills, and attitudes expected of each level. Examples for the competency for early learner/novice practitioner include the following: Have awareness of common ethical issues in cancer care (knowledge); demonstrate ability to discuss, educate, and counsel patients and their support persons(s) regarding preferences (skills); and appreciate the impact of culture, the sensitivity, and diversity of attitudes in relation to cancer (attitude). Expert practitioner examples include: recognition of need for, and ability to advocate for challenges involving equity and access in order to improve health outcomes (skill) and awareness of workplace complexities, such as provider roles, team functioning, and organizational environments affecting patient-practitioner relationships (attitude).
The de Souza Interprofessional practice cancer competency framework provides a set of shared competencies and a novice to expert pathway for clinicians across disciplines and supports a more standardized learning and comprehensive approach in organizing professional development towards a coordinated, high quality, and person-centered care.
随着癌症护理需求的持续增长，医疗系统需要一支由受过高等教育的专家和通才组成的劳动力队伍，以便在各种环境下提供连续的护理。
由加拿大德索萨研究所牵头，成立了一个跨学科工作组，旨在为参与癌症护理的受监管卫生专业人员制定一个具有相关性的能力框架。
工作组收到了国家和国际肿瘤学指南、标准和能力的范围审查结果，以及继续教育机会和对临床医生最相关的肿瘤学主题的需求评估数据。来自家庭医学、药学、社会工作、心理学、职业治疗和护理等领域的 51 名专业人员参加了七个焦点小组。另外 32 名护士参加了一项护理特定需求评估调查。使用改良德尔菲技术，工作组成员进行了三轮迭代，以审查数据，并就与三个专业水平相关的能力项目达成共识，从早期学习者/新手从业者、进阶从业者到专家从业者。
达成了最终共识，选择了反映最佳癌症护理的能力，并将其映射到三个专业水平，以及每个水平预期的知识、技能和态度。早期学习者/新手从业者能力的例子包括：对癌症护理中常见伦理问题有认识（知识）；展示讨论、教育和咨询患者及其支持人员（技能），并了解文化、态度的敏感性和多样性对癌症的影响（态度）。专家从业者的例子包括：认识到需要并能够倡导涉及公平和获得的挑战，以改善健康结果（技能），并了解影响患者-从业者关系的工作场所复杂性，如提供者角色、团队功能和组织环境（态度）。
德索萨跨专业实践癌症能力框架为跨学科的临床医生提供了一套共同的能力和从新手到专家的途径，并支持更标准化的学习和全面的方法，以组织专业发展，实现协调、高质量和以患者为中心的护理。
