Occupational Health Competency Framework for Public Health in Québec
The underlying impetus of the occupational health framework is a desire to enact change. This tool aims to address the modernization challenges outlined in the Programme national de santé publique (MSSS, 2008) [Québec's updated public health program] and the Plan stratégique du Réseau de santé publique en santé au travail (MSSS, 2010) [the strategic plan of Québec's public health network in occupational health, and it offers a wide range of opportunities for organizational and professional development, including staffing, development of a joint training plan, personnel recruitment and assessment, career management, orientations for university programs, harmonization of practices, etc. Moreover, the use of the interdisciplinary professional situations of the RSPSAT as a blueprint for describing the competencies highlights the framework's collective nature and allows for implementation of a comprehensive competency development plan.
The competency framework development process
The professional situations—essential for developing the framework—are gathered from the field, by recruiting workers to participate in the process of reflecting on their own professional practices. Thus, from January to March 2011, consultations were held with four discussion groups from various regions in Québec (Côte-Nord, Saguenay–Lac-Saint-Jean, Montréal, Abitibi-Témiscamingue, and Mauricie et Centre-du-Québec) and with representatives of the occupational health professions (physicians, ergonomists, coordinators, clinical nurses and nursing consultants, occupational hygiene technicians and occupational hygienists, research officers). Thirty-four (34) participants helped create the database of occupational health professional situations (raw data). Meantime, a working group was established and activities resumed in 2012.
The working group tasked with developing the occupational health competency framework was representative of the national, regional and local population of the occupational health network. It was composed of a public health director, a regional coordinator, a local coordinator, and representatives from the occupational health teams, i.e., physicians, clinical nurses and nursing consultants, occupational hygiene technicians, occupational hygienists, ergonomists, research officers and audiologists, all from various regions in Québec, and all of whom had at least five years' experience in occupational health. The situations gathered from focus groups were then analyzed and classified into families of situations. From each family of situations emerged a competency. The reference definition for the framework is that of Tardif (2006), according to which each competency is developed through the effective mobilization and combination of a variety of internal resources belonging to the individual and external resources present in the environment (experts, peers, references, software, information and communication technologies, etc.), within a family of situations. This is why the identification of the resources needed to develop the competency was an important part of the process.
Three families of professional situations
The iterative nature of the process involved frequent back-and-forth interactions between the various stages of the project. An integral part of the entire process was the validation of results by representative groups of individuals. Furthermore, with the aim of standardizing certain terms and, thereby, developing a shared vision, the working group held many discussions on terminology. These efforts allowed tacit knowledge, the raw data on professional situations from May 2012, to be converted (as of January 2013) into explicit knowledge, i.e., the formulation of RSPSAT competencies and their precise descriptions. The three families of professional situations retained were:
- Development of our services as a RSPSAT
- Contribution of our expertise as a RSPSAT for the management of occupational health risks
- Support for workplaces during the change process
The Development of our services as a Réseau de santé publique en santé au travail (RSPSAT) family comprises all the professional situations related to monitoring, planning, organization, implementation and evaluation.
The contribution of our expertise as a RSPSAT for the management of occupational health risks family comprises all the professional situations for which the RSPSAT provides expertise in managing occupational health risks. More specifically, it involves carrying out workplace characterization activities and finding ways to eliminate, control and reduce risks to worker health. This family is characterized by its technical and scientific content as prescribed in the Programme de santé spécifique à l'établissement [institution-specific health program], the Pour une maternité sans danger program [For a Safe Maternity Experience program], the notifiable diseases information system, etc.
The Support for workplaces during the change process family comprises all the professional situations related to providing support to actors during the process of introducing changes in the workplace. Change is a key part of improving occupational health and mobilizing workplaces. This family of situations is unique in that the statements outline how activities are operationalized rather than any content to be acquired. Hence, it focuses on the social and relational aspects of occupational health, within the context of an evolving shared vision.
The identification of the internal and external resources needed to master these competencies was useful in creating a portrait of each competency. The internal resources include declarative knoledge (knowledge), procedural knowledge (know-how or experience) and attitudes (soft skills, values). For their part, the external resources are those found in the environment and which are necessary to the development of the competency, including, for example, guidelines (laws and regulations, orientations, policies), tools (software, technologies), databases, bibliographic references, networks and partners, and training sessions.
Competency framework assimilation process
The first step in the framework assimilation process involved the series of validations carried out among the representative groups. The members of the working group then presented the framework in a more formal manner to both their work teams and their professional associations, whereas the regional and local occupational health managers were, for their part, invited to attend an information session. A meeting of the Table de concertation nationale en santé au travail (TCNSAT) [national issue table on occupational health] and a round of visits to five professional associations were also organized. To ensure the framework's sustainability, a number of activities need to be planned, such as, for example, the implementation of mechanisms for updating the competency framework. The occupational health competency framework must be an evolving tool that systematically incorporates changes.