Dichotomy and dialogue in conceptualizations of competency in health professionals’ education

Abstract

Most research on the definition of competency and its application in health professionals’ education programs is focused on semantic matters, while contextual influences are rarely discussed or solely presented as background context. The aim of this article is to gain a comprehensive understanding of the issues raised by definitions of competency and to describe the contextual factors that have given rise to those definitions. This is achieved by presenting the results of a literature review that synthesized different conceptualizations of competency. We analyzed relevant literature listed in the CINAHL, Embase, MEDLINE, and PsycINFO databases as of 2015. The results show that authors define competency based on two diverging driving forces: one aimed at professional regulation and the other at professional emancipation. The analysis revealed common grounds between these perspectives. From these common grounds we discuss the possibility of conceptualizing competency on a continuum instead of perpetuating the dichotomized discourses presented in the current literature. The integration of both perspectives gives the opportunity to rethink policies, structures and strategies of professional education toward an integrated perspective of professional development situated in a lifelong learning enterprise, achieving both minimal professional standards and excellence in healthcare practices from initial education throughout a career.