The effectiveness and impact on performance of pharmacy-related competency development frameworks: A systematic review and meta-analysis

Background: Competency frameworks for education, training and development are widely used in the health professions, including pharmacy. Published studies suggest that competency frameworks have an impact on professional performance. Professional performance that is consistent with up-to-date knowledge and skills influences health care quality and patient safety. This review assessed the effectiveness of competency frameworks in facilitating improvement in pharmacists' performance.

Method: PubMed/Medline, CINAHL, Embase, ERIC, PsycINFO and Scopus electronic databases were searched to identify relevant literature. The findings of the included studies were synthesised qualitatively, and via a meta-analysis. The meta-analysis evaluated the odds of improved competency behaviour as a proxy measure of impact on pharmacists' performance. Study quality was assessed using 12 criteria adapted from the EPPI-Centre guidelines v0.9.7. The protocol for this review is registered on PROSPERO with reference number CRD42018096580.

Results: In total, nine interventional studies were identified for review. The review findings showed observable and significant improvement in pharmacists' performance when competency frameworks are used to appraise performance, identify knowledge gaps, and tailor learning activities. A meta-analysis that involved a total of 348 pharmacists undergoing repeat peer assessment showed pooled odds for improved competency behaviour of 4.41 (95% CI: 1.89-10.29, I² = 83%). Subgroup analyses showed pooled odds with corresponding 95% CI of 6.50 (1.77-23.97, I² = 77%) vs 2.95 (0.59-14.72, I² = 93%) for the studies that were conducted in countries within or outside Europe, respectively; 10.51 (3.73-29.62, I² = 24%) vs 2.39 (0.96-5.95, I² = 87%) for studies with reassessment conducted at ≤6 months from baseline, or more, respectively; 6.68 (1.63-27.45, I² = 88%) vs 2.80 (0.86-9.07, I² = 74%) for studies involving hospital or community pharmacists, respectively; and 2.80 (1.22-6.45, I² = 77%) for studies with low risk of bias.

Conclusion: These findings suggest competency frameworks facilitate improvement in pharmacists' performance; however, further evaluative studies are needed.