Refreshed Enriched Core Competency Framework for Health Services and Policy Research

The Pan-Canadian Training Modernization Task Force (see members below) has released the Refreshed Enriched Core Competency Framework for Health Services and Policy Research.  The refreshed framework aims to advance a vision for “A highly skilled health services and policy research workforce with the knowledge, skills, and capabilities to actively engage with and display leadership to advance high-performing, equity centred learning health systems that are relentlessly committed to data, evidence, and continuous improvement.”

The Enriched Core Competency Framework for Health Services and Policy Research (Transcript)

Meghan McMahon
The challenges confronting health systems in Canada and internationally are only growing in complexity.

Carl-Ardy Dubois
[Health inequalities, chronic diseases, pandemic health threats, the emergence of new social needs.]

Adalsteinn Brown
We've confronted for years this know-do gap. We have evidence. We have data, but we're not always able to deploy it.

Tracy Wasylak
Healthcare is changing. We need to change with it, and we need to build the skills of the future.

Beverley Essue
A heightened awareness of the importance of thinking about decolonial approaches to learning and epistemic justice has really called on all of us who work within health systems to think about how we can value the diverse perspectives that are reflected within our spaces.

Rick Glazier
Over the past decade, we've had numerous challenges that impact the skills required of health services and policy researchers.

Tammy Clifford
It's critical that health services and policy research training also evolves to recognize both research and leadership skills.

Steini Brown
The framework's really about creating a future-ready workforce. The type of people who will have that deep, profound understanding and expertise in health services and health policy.

Meghan McMahon
It aims to equip the next generation of health services and policy researchers with the skills, the tools and the capabilities to make an impact.

Antoine Groulx
[It’s a conceptual framework that has many advantages. The first is incorporating almost every facet of skill that we’re looking for within the same image.]

Steini Brown
You also have people who will have the leadership skills to build teams, to build networks, to understand and be able to explain how evidence will drive improvement within our health system.

Alyssa Indar
Complex is the word that everyone is using to describe our healthcare system right now.

Carl-Ardy Dubois
[The health system is currently facing a high number of societal challenges.]

Rick Glazier
And the skills that we need inside the health system to help generate appropriate evidence and bring evidence to policy decisions is needed now much more than ever.

Alyssa Indar
And we need evidence-informed and innovative strategies more than ever.

Rick Glazier
Members of our society have been systematically excluded. Racism is pervasive throughout our system, increased focus on equity, diversity, inclusion, and ableism is really, really important.

Meghan McMahon
What's great and what's really unique about this framework is that it blends research and professional skills.

Rick Glazier
Just all of the things that we need in our health systems to be the change agents.

Meghan McMahon
It incorporates leadership. It incorporates project management. It incorporates skills in change management and collaboration.

Tammy Clifford
It features an important blend of research and professional skills and leadership and other key professional domains and certainly will help build a workforce.

Meghan McMahon
The framework features nine core competencies and two transversal domains.

Tracy Wasylak
Change management, implementation, project management capability.

Rick Glazier
Policy, implementation, communication.

Meghan McMahon
And it packages all that together in an enriched core competency framework that centers two transversal domains in equity, diversity, inclusion, and anti-oppression, and Indigenous cultural safety and humility.

Kimberly Fairman
Competencies that address indigenous worldview and indigenous approaches to health care and health policy research.

Antoine Groulx
[It’s a conceptual framework that includes a broad focus on everything related to First Peoples as well as equity, diversity and inclusion.]

Beverly Essue
Inclusive perspectives on how to create a space that values all perspectives that reflect the diversity of the population that we have here in Canada.

Carl-Ardy Dubois
[Gaps that currently linger in training programs and generally left little room for EDI issues and relations with Indigenous people.]

Meghan McMahon
And this framework provides opportunity and explicit attention to those skills as critical in the health system leaders toolkit.

Rick Glazier
CHR has adopted the core competencies and the refreshed core competencies. The IHSPR has been involved with the training modernization working group from the very beginning.
We feel this is a journey and not a destination. And we're also not thinking that this is limited to training programs. I think all of us, whatever our roles in the health system, really need to focus on all of the competencies.

Beverly Essue
As many people as possible who are developing expertise in research to understand how they can best leverage that research knowledge in spaces where they stand to have impact.

Deepa Singal
We've seen great success at the Health System Impact Fellowship level of the implementation of this framework and how we train fellows, and it would be amazing to see this framework adopted in other settings.

Tracy Wasylak
And the framework really helps you to hone in on some very specific areas so that you can focus and finish.
Beverly Essue
It responds very squarely to this gap, but I would envision a world where all of our trainees have an opportunity to think about leadership.

Alyssa Indar
For me, it also provides an outline of the skills and knowledge that I need to develop into an emerging leader or a leader that can really navigate change within our current systems.

Antoine Groulx
[I think it’s a framework that can resonate with any home university or home province. I think the concepts it includes are widely accepted across the country.]

Tammy Clifford
It enables Pan-Canadian collaboration because the trainees have a similar foundation in terms of these very important research and leadership skills.

Antoine Groulx
[I also think it would be good for everyone to get on board so that we can work better together and benefit from collaboration between the country’s academic communities.]

Steini Brown
As you see the framework become more and more common, you should see a lot of things change in our system. You'll see the types of competition and improvement that we want.

Meghan McMahon
What this framework does is provide opportunity for students to develop those skills. So that when they graduate, they can contribute within academic careers. They can contribute as health system leaders and they can contribute towards the advancements of learning health systems.

Kimberly Fairman
This element of inclusion to me is what's most inspiring and beneficial about the enriched competencies. I think it gives everyone an opportunity to see how they fit into the system.

Deepa Singal
Adopting the framework into our training environments is a game change for health services and policy researchers across the country in order for them to use their research skills to inform and catalyze real system change.

Antoine Groulx
[I think it’s a model or conceptual framework that will promote sustainable research funding, because we’ll be in a world that’s closer to the one decision-makers are used to.]

Tammy Clifford
There's one framework that we can use and by doing so, we're speaking the same language for those who are then the users of all of this.

Carl-Ardy Dubois
[This will ensure that Canada has a new generation of researchers, which is essential for pursuing a variety of careers and making a difference in organizations in the health system.]

Beverly Essue
In my mind, that's the testament of a framework that has relevance and a framework that resonates and a framework that stands to have broad impact.

Rick Glazier
The importance and the necessity of undertaking that very challenging and difficult work of changing ourselves, our institutions, and our systems.

What’s in the Framework?

The refreshed framework features nine essential competencies that emphasize rigorous scholarly preparation in health services and policy research (HSPR) methods and the development of leadership, implementation, and other professional skills deemed essential to contribute to evidence-informed health system improvement and learning health systems. Additionally, the refreshed framework includes two new transversal domains: Equity, Diversity, Inclusion, Accessibility and Anti-Oppression; and Indigenous Cultural Safety and Humility. These domains are considered fundamental principles to be embedded into all aspects of HSPR training, fostering more inclusive and equitable leaders and healthcare systems. Figure 1 features the refreshed competencies and transversal domains. Table 1 provides competency and domain definitions.

How was it refreshed?

The competency framework was refreshed using a pan-Canadian, community-engaged, evidence-informed refresh process (Fall 2022- Spring 2024) led by the Pan-Canadian Training Modernization Task Force.  It builds on the original 2015 Enriched Core Competency Framework for HSPR, which was adopted with success by several federal and provincial fellowship programs, including the Health System Impact Program. Since 2015, however, the contexts in which health systems operate, the challenges they confront, and the needs of the communities they serve have continued to evolve. These changes affect the research questions, required skills, and employment opportunities for health services and policy researchers, prompting a refresh of the framework.

Who can use it?

The refreshed framework allows for flexible implementation and is intended to serve as a resource for multiple audiences, including:

  • Trainees, postdoctoral and early career researchers, who can use the framework to guide their professional development and inform their selection of training programs.
  • Doctoral programs, who can use the framework to guide the development of new courses and training opportunities, the creation of partnerships with health system organizations to support experiential learning opportunities, and the modernization of existing curricula.
  • Employers, who can use the framework to inform their own talent development and hiring programs, ensuring that their organizations cultivate cultures and capabilities that enhance their engagement with and maximize the value derived from research.
  • Research funding programs, who can use the framework to guide their capacity development and training activities and offerings.

Read the refreshed competency framework report [ PDF (410 KB) - external link ].

Figure 1: The Refreshed Enriched Core Competency Framework Domains

Table 1: Refreshed Competency Domains and Definitions
Domain Definition
Equity, Diversity, Inclusion, Accessibility and Anti-Oppression To know how to assess health equity and apply research methods to advance equity and anti-oppression in health services, policies, and outcomes, and to be able to incorporate intersectionality and equity, diversity, inclusion, and accessibility (EDIA) principles in research and practice.
Indigenous Cultural Safety and Humility To know how to have meaningful and culturally safe engagement and research practices with Indigenous Peoples, to develop respectful relationships and humility, and to help address anti-Indigenous racism.
Leadership and mentorship The ability to lead self and lead others, develop a vision and inspire collaboration to advance shared goals, display innovative and solution-oriented thinking, build and lead collaborative teams, provide mentorship and sponsorship to support others’ growth, and foster cultures of continuous learning and improvement.
Innovation, Implementation, and Improvement The ability to create and implement new and better ways to improve health system outcomes, foster the systematic uptake of research findings in the health system by using implementation and/or improvement methods, contribute to continuous learning and improvement, and advance LHS capabilities.
Engagement, Collaboration, and Partnership The ability to design and participate in appropriately tailored, culturally safe, diverse, inclusive, and effective engagements (e.g., with patients, communities, providers, and partners), build and work effectively and respectfully within interdisciplinary and intersectoral collaborations and partnerships to advance shared goals, and network to develop diverse and productive relationships.
Project Management The ability to plan, coordinate, and manage all stages of projects (and programs with a portfolio of projects) from idea conception to knowledge dissemination and to anticipate and manage risks.
Communication The ability to communicate technically complex information and evidence clearly, appropriately, and with impact to varying audiences.
Knowledge mobilization The ability to employ the science and practice of knowledge mobilization to design and co-produce relevant research, to integrate research evidence with other forms of evidence and ways of knowing, and to support the use of research findings in policy and practice to inform health system improvement.
Health Systems, Policy Processes, and Systems Science To have knowledge of Canadian and international health systems and institutions, of how health care systems operate and interconnect with other sectors, of how policies and decisions are made, o how to use systems science for research and implementation, and of how to adapt research evidence for the local contexts (i.e., socio-political, economic, environmental).
Research and Evaluation The ability to ask meaningful and relevant research and evaluation questions, have knowledge of a broad range of theories and methods, and be able to identify and use them appropriately and ethically, analyze health system interventions (e.g., policies, programs, service delivery models) and their implementation in complex settings, develop evidence-informed interventions and solutions, and reflect critically on the evidence to identify practical considerations and options for improvement.
Data science The ability to analyze, interpret, and generate insight from a wide range of data and information systems (including data derived from electronic and administrative health records and lived experience) to address health system challenges and improve outcomes.

Training Modernization Task Force Members

Co-Chairs

  • Dr. Adalsteinn Brown, Dean & Professor, Dalla Lana School of Public Health, University of Toronto
  • Dr. Stephen Bornstein, Professor, Memorial University of Newfoundland
  • Dr. Carl-Ardy Dubois, Dean & Professor, School of Public Health, Université de Montréal
  • Dr. Shanthi Johnson, Vice-President, Research and Innovation, University of Windsor

Members

  • Rhonda Boateng, Lead, CIHR Institute of Health Services and Policy Research
  • Anna Greenberg, Executive Vice President and Chief Operating Officer, Ontario Health
  • Kimberly Fairman, Health System Leader & PhD candidate, University of Victoria
  • Dr. Rick Glazier, Scientific Director, CIHR Institute of Health Services and Policy Research
  • Dr. Deborah Marshall, Professor, Cumming School of Medicine, University of Calgary
  • Dr. Meg McMahon, Associate Scientific Director, CIHR Institute of Health Services and Policy Research
  • Dr. Matthew Menear, Researcher and Assistant Professor, Université Laval
  • Dr. Denis Roy, Medical Advisor, Ministry of Health and Social Services, Québec
  • Dr. Tara Sampalli, Health System Leader & Faculty, Dalhousie University
  • Dr. Deepa Singal, Scientific Director, Autism Alliance of Canada
  • Tracy Wasylak, Health System Leader & Assistant Professor, University of Calgary

Acknowledgements

The Pan-Canadian Training Modernization Strategy and Initiative has reflected the leadership and wisdom of a remarkable community of individuals who share a commitment to building the human capital to advance learning health systems and evidence-informed health system transformation. The Task Force and CIHR-IHSPR acknowledge and thank the following individuals for their wisdom and contributions: Dr. Robyn Tamblyn, Erin Thompson, Dr. Jessica Nadigel, Melissa Tamblyn, Dr. Terry Sullivan, the inaugural Training Modernization Working Group (2016 – 2018), Dr. Diane Finegood, and the health services and policy research community that has helped inform, use, and advance the competencies.

Enriched core competencies (2015)

Excerpt from the Report from the Working Group on Training [ PDF (323 KB) - external link ]

The attributes and competencies outlined in Figure 1 and Table 1, below, provide the foundation for the recommendations on modernizing HSPR training that are outlined in the report.

Recommended attributes and competencies

During the course of its deliberations, the Working Group reached consensus on eight attributes and competencies that should be included or further emphasized in the training of HSPR doctoral graduates. These competencies are based on a comprehensive literature review and consultations with Working Group members as well as potential employers. These additional skills will allow graduates to work in academic settings but also to move into non-academic careers in the private or public sector. Based on discussions at the March 2016 Training Modernization Workshop in Toronto, two additional competencies were added: (1) change management and implementation; and (2) dialogue & negotiation. Figure 1 illustrates the enriched core competencies. Table 1 provides descriptions of each competency.

Figure 1: Enriched core competencies

Table 1: Recommended attributes/competencies
Skills Attributes/competencies Description
Research and analytic skills Analysis and Evaluation of Health and Health-Related Policies and Programs The ability to effectively carry out formative and summative evaluation with strong links to organizational improvement and planning. Includes technical skills, contextual awareness, communication skills, analysis skills and research skills.
Analysis of Data, Evidence and Critical Thinking The ability to collect, analyze and use a wide range of data and to reflect critically on and incorporate theory and research evidence iteratively to clarify problems, frame options and identify implementation considerations in both academic and non-academic settings. Includes big data, administrative data and economic data.
Understanding Health Systems and the Policy Making Process Excellent knowledge of the Canadian and international health policy system from both academic and real-world perspectives.
Knowledge Translation, Communication and Brokerage The ability to use multiple methods of communication and to communicate appropriately with different kinds of audiences.
Professional skills Leadership, Mentorship and Collaboration The ability to lead, organize and support teams from various backgrounds to work together to achieve a specific outcome.
Project Management The ability to coordinate and organize all stages through to KTE of a project in an academic and non-academic environment.
Interdisciplinary Work The ability to use effectively and to combine when appropriate methods and insights from multiple academic disciplines (e.g., humanities, social sciences, management, epidemiology, medicine, etc.)
Networking The ability to develop and maintain productive relationships within and outside of academia across the health system.
Dialogue & Negotiation The ability to work towards win-win outcomes and value-added results, including understanding other perspectives and how to respond.
Change Management and Implementation The ability to plan, manage and implement change, including: to communicate a clear vision for change; to lead people and organizations through change; to manage and implement successful transitions; and to evaluate and report on change.
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