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The Definitions and Conceptualizations of the Practice Context in the Health Professions: A Scoping Review
Aliki Thomas1, Annie Rochette, Catherine George
1Dr. Thomas: Associate Professor, School of Physical and Occupational Therapy, Research Scientist, Institute of Health Sciences Education, McGill University. Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada . Dr. Rochette: Professor, Occupational Therapy Program, School of Rehabilitation, Université de Montréal. Centre for Interdisciplinary Research in Rehabilitation, Institut universitaire sur la réadaptation en défience physique de Montréal (IURDPM), Montreal, Quebec, Canada. Ms. George: School of Physical and Occupational Therapy, McGill University. Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada. Dr. Iqbal: Post-doctoral fellow, School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University. Centre for Interdisciplinary Research in Rehabilitation Montreal, Quebec, Canada. Ms. Ataman: School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University. Centre for Interdisciplinary Research in Rehabilitation Montreal, Quebec, Canada. Dr. St-Onge: Professor, Department of Medicine and Center for Health Professions Pedagogy, Université de Sherbrooke. Paul Grand'Maison de la Société des Médecins de l'Université de Sherbrooke - Research Chair in Medical Education, Sherbrooke, Quebec, Canada. Ms. Boruff, Associate Librarian, Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, Quebec, Canada. Dr. Renaud: Professor, Department of Family and Emergency Medicine, VITAM Research Center, Université Laval, Quebec, Quebec, Canada.
Introduction:
Health care professionals work in different contexts, which can influence professional competencies. Despite existing literature on the impact of context on practice, the nature and influence of contextual characteristics, and how context is defined and measured, remain poorly understood. The aim of this study was to map the breadth and depth of the literature on how context is defined and measured and the contextual characteristics that may influence professional competencies.
Methods:
A scoping review using Arksey and O'Malley's framework. We searched MEDLINE (Ovid) and CINAHL (EBSCO). Our inclusion criteria were studies that reported on context or relationships between contextual characteristics and professional competencies or that measured context. We extracted data on context definitions, context measures and their psychometric properties, and contextual characteristics influencing professional competencies. We performed numerical and qualitative analyses.
Results:
After duplicate removal, 9106 citations were screened and 283 were retained. We compiled a list of 67 context definitions and 112 available measures, with or without psychometric properties. We identified 60 contextual factors and organized them into five themes: Leadership and Agency, Values, Policies, Supports, and Demands.
Discussion:
Context is a complex construct that covers a wide array of dimensions. Measures are available, but none include the five dimensions in one single measure or focus on items targeting the likelihood of context influencing several competencies. Given that the practice context plays a critical role in health care professionals' competencies, stakeholders from all sectors (education, practice, and policy) should work together to address those contextual characteristics that can adversely influence practice.
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