Assessing Competency in Healthcare Learners and Professionals to Inform the Chiropractic Profession; A Systematic Review and Thematic Analysis.

Objectives: Competency Based Education (CBE) and assessing competency of individuals within the chiropractic profession, both at an undergraduate and post-graduate level remains a challenge. Many stakeholders, including commissioners of healthcare services, healthcare regulators, insurance companies and the public are invested in understanding levels of competency within the chiropractic profession. This paper seeks to explore competency assessment tools currently used within healthcare professions. Furthermore, we consider how common themes identified could be practically applied to the chiropractic profession. Methods: A systematic review was completed adhering to appropriate PRISMA reporting standards. A Braun and Clarke thematic analysis was then completed to identify themes embedded in the literature. 8 research databases were used to search defined search strings. Results: 189 articles were identified, duplicates were removed, and inclusion exclusion criteria were then applied. 6 key themes were identified following the thematic analysis; mapping learning to competency, importance of feedback, assessment is critical, assessment differentiation is possible, scaffolded learning, and individualization. Conclusion: These 6 themes highlight areas of commonality across multiple healthcare sectors. By evaluating approaches various healthcare professions take to competency assessment, we were able to consider how the chiropractic profession could learn from these approaches. We explore how existing frameworks for robust professional learning activity and defining professional competency could be built into the chiropractic profession. Finally, we discuss how knowledge exchange into chiropractic from other professions is something the chiropractic profession should embrace, for a potentially wider, multifactored benefit