The term competence appears in many forms and guises in the research literature on the professions. Nevertheless, competency is defined as the combination of knowledge, skills, traits and attributes that collectively enable a person to perform the tasks and roles required up to the expected standard (Benedict du Boulay, 2001).
The concept of competency bears other names such as mental capacity and decision-making ability, the former being the most significant to medicine (Whitney Durand, 2003).
Moreover, the increasing codification and regulation of medical competence highlights the multi-faceted and complex nature of being a doctor. Not only are extensive skills and knowledge expected within the doctor's area of specialization, but also high levels of communicative ability, ethical understanding and responsibility, team working capability and organizational ability are considered.The following are some examples of general competencies associated with doctors.
Firstly is the Humanistic Practice of Medicine which means to recognize and appropriately manage so-called ``difficult patients,'' including their personality disorders and problematic behavioral patterns. In addition, understand the concepts of the health belief model; know how to elicit it and how to work constructively in a patient-centered way with persons from different cultural groups.
Next is professionalism which means to show a commitment to standards for lifelong excellence by continuously adding to one's knowledge of medicine and by drawing the distinction between knowledge that is based on high-quality evidence and knowledge from anecdote and personal experience.
Then, the third competency is medical ethics which means to know what to do when the patient refuses a recommended medical intervention in both emergency and non-emergency situations. Know how to handle the following situations related to end-of-life care: withholding or withdrawing life-sustaining treatment, including nutrition and hydration, communicating ``bad news'' and listening for the patient's and family's concerns, writing ``do not resuscitate'' orders, requests for physician-assisted suicide or euthanasia, know how to address requests to breach confidentiality and know the principle of truth-telling and how to implement it in situations involving information disclosure and medical errors.
Next, is the medical interview which comprises the use of the interview to identify cognitive impairment, anxiety, denial, and defensiveness; be able to manage each during the interview (Sox et al, 1997).
Then comes the management competency in which teamwork, management and leadership skills are needed on a wide range of contexts: within the relevant care groups and the medical practice or firm; and in order to perform duties needed for the effective and efficient functioning of the health care organization in the interests of its patients, employees and other stakeholders. Interprofessional communication, team working skills, record-keeping are frequently cited examples. So are teaching and training; but not appraising, mentoring and giving feedback (Benedict du Boulay, 2001).
Finally, we come to the competence to manage one's job as a whole. This includes determining priorities, implementing professional values, improving the quality of one's personal practice, self-evaluation for all one's roles and duties, monitoring one's own health and stress-level and taking appropriate action(Benedict du Boulay, 2001).
In conclusion, the definition for competency can be applied to a professional at any stage in their career and their current competence has to meet this service expectation as it changes with increasing experience and seniority. In addition competent doctors also seek to expand their competence to meet anticipated future responsibilities; and this dual obligation presents a considerable challenge. Their success in meeting this challenge is affected by the balance between the demands of their job and the opportunities presented by their learning programme (Benedict du Boulay, 2001).
. Reference List:
Benedict du Boulay (2001), Sox (1997). Competence and judgment. Retrieved February 20, 2009. Website: http://www.cogs.susx.ac.uk/users/bend/doh/reporthtm/node4.html
Whitney Durand (2003). Competency. Retrieved February 19, 2009. Website: http://www.selegal.org/competency.htm
This essay on competency was an assignment for me, and i thought of posting it for others to read since i felt that i must also contribute to this wonderful site and be a part of it. i want peoples thoughts (especially the future doctors) to ponder over their competencies and to build in the characteristics which are they feel are weak in them.