Medical doctors' job specification analysis: A qualitative inquiry.

Current understanding of medical doctor competencies is limited to standardized frameworks like the NKLM, which may not fully reflect real-world workplace behaviors. Prior research has shown that competency models often lack input from multiple stakeholder perspectives. No prior work had resolved how patient views differ from those of medical professionals and staff. This gap motivated an investigation into how different groups define essential competencies for medical doctors. Existing studies focus on theoretical models rather than empirical data from workplace incidents. The NKLM includes behaviors not observed in practice, suggesting a disconnect between theory and application. This uncertainty drove the need to examine critical incidents and behaviors across multiple professional fields. No prior work had resolved how to integrate diverse perspectives into competency frameworks.

This study aimed to identify and categorize the competencies required by medical doctors through a qualitative analysis of critical workplace incidents. The specific problem addressed is the lack of empirical evidence linking competency models to real-world medical practice. The motivation stems from the need to align educational frameworks with actual job demands. The study sought to compare perspectives from medical doctors, non-medical staff, and patients. It aimed to determine whether existing competency models like the NKLM align with observed behaviors. The goal was to identify competency clusters relevant across medical fields. The study also aimed to highlight differences in competency perception among stakeholder groups. This approach was chosen to improve the accuracy of competency-based education and personnel development.

Structured interviews were conducted with 74 participants representing three professional fields and three stakeholder groups. Critical incidents and behaviors were analyzed to identify recurring themes. The NKLM was used as a reference to compare interview findings. Participants included medical doctors, non-medical staff, and patients. Each interview focused on specific professional fields like clinical theory and practice. The analysis categorized behaviors into three competence clusters. The NKLM was cross-referenced to assess alignment with interview data. The method ensured that both observed and theoretical competencies were evaluated.

Eleven competencies were identified and grouped into three clusters: interpersonal, work-related, and self-related. Medical doctors and non-medical staff cited all eleven competencies. Patients omitted one interpersonal and two self-related competencies. The NKLM included most critical behaviors mentioned in interviews. However, the NKLM also contained behaviors not observed in practice. The majority of behaviors from interviews were already in the NKLM. This suggests partial alignment between theoretical and observed competencies. The patient perspective revealed unique omissions in competency perception.

The study found that the NKLM aligns with most observed behaviors but includes some unobserved competencies. Competency clusters identified in interviews were consistent with existing models. Patient perspectives revealed notable differences in competency perception. These findings suggest that competency frameworks may benefit from incorporating patient input. The results can inform the development of selection and training exercises. They also support the design of discipline-specific potential appraisals. The authors propose replicating these findings with quantitative methods. Future work aims to define competencies for medical education and personnel development.